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1154665909
CASSIE BREANNA ILYASOVA
ROME, GA
NPI
1154665909
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 7137)
Enumeration Date
2012-11-17
Last Update Date
2023-10-27
Business Address
CASSIE BREANNA ILYASOVA PA-C
504 REDMOND RD NW
ROME, GA 30165-1416
Phone number: 762-235-3130
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Mailing Address
CASSIE BREANNA ILYASOVA PA-C
221 TECHNOLOGY PKWY NW
ROME, GA 30165-1369
Phone number: 762-235-1000
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