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1417388232
TRACEY LORENA TELLO
ATLANTA, GA
NPI
1417388232
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: GA 146587)
Enumeration Date
2013-12-04
Last Update Date
2018-11-28
Business Address
Miss TRACEY LORENA TELLO CSFA, ST
931 MONROE DRIVE NE SUITE 102 #641
ATLANTA, GA 30308-7132
Phone number: 404-312-1633
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Mailing Address
Miss TRACEY LORENA TELLO CSFA, ST
931 MONROE DR NE SUITE 102 #641
ATLANTA, GA 30308-1793
Phone number: 404-312-1633
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