KATIE DIANA FOUNTAIN

ROME, GA
NPI1548671472
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: GA  007228)
Enumeration Date2014-05-14
Last Update Date2017-07-10
Business Address
-- KATIE DIANA FOUNTAIN PA-C
1825 MARTHA BERRY BLVD NW
ROME, GA 30165-1625
Phone number: 706-295-5331
Mailing Address
-- KATIE DIANA FOUNTAIN PA-C
PO BOX 911589
DENVER, CO 80291-1589
Phone number: 505-923-6100
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