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1104925007
GERALD BORTOLAZZO
AUSTELL, GA
NPI
1104925007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: GA 017997)
Enumeration Date
2006-09-21
Last Update Date
2008-01-31
Business Address
-- GERALD BORTOLAZZO
3950 AUSTELL RD
AUSTELL, GA 30106-1121
Phone number: 770-732-4000
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Mailing Address
-- GERALD BORTOLAZZO
5665 NEW NORTHSIDE DR
ATLANTA, GA 30384-0001
Phone number: 770-874-5400
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