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1619128741
BRANDY NICHOLS OWENS
LAGRANGE, GA
NPI
1619128741
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Former Name
BRANDY ELIZABETH NICHOLS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: GA 005435)
Enumeration Date
2008-10-07
Last Update Date
2021-06-28
Business Address
Mrs. BRANDY NICHOLS OWENS PA
1514 VERNON RD
LAGRANGE, GA 30240
Phone number: 706-880-7222
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Mailing Address
Mrs. BRANDY NICHOLS OWENS PA
1514 VERNON RD
LAGRANGE, GA 30240-4131
Phone number: 706-880-7222
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