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1356812135
UI AN
DECATUR, GA
NPI
1356812135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 8962)
Enumeration Date
2018-12-05
Last Update Date
2021-06-01
Business Address
UI AN
1670 CLAIRMONT RD
DECATUR, GA 30033-4004
Phone number: 404-321-6111
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Mailing Address
UI AN
PO BOX 134
TYRONE, GA 30290-0134
Phone number:
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