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1417020405
KIZUWANDA BLACKBURNE
STOCKBRIDGE, GA
NPI
1417020405
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 5126)
Enumeration Date
2006-11-16
Last Update Date
2008-04-01
Business Address
-- KIZUWANDA BLACKBURNE RPAC
145 EAGLES WALK SUITE A
STOCKBRIDGE, GA 30281-7340
Phone number: 770-389-3855
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Mailing Address
-- KIZUWANDA BLACKBURNE RPAC
145 EAGLES WALK SUITE A
STOCKBRIDGE, GA 30281-7340
Phone number: 770-389-3855
Copy
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