TERESA BOUTWELL

OXFORD, GA
NPI1669543203
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: GA  91956)
Enumeration Date2006-11-13
Last Update Date2007-07-08
Business Address
-- TERESA BOUTWELL CST
70 ASHFORD DR
OXFORD, GA 30054-4648
Phone number: 770-985-4257
Mailing Address
-- TERESA BOUTWELL CST
PO BOX 1938
CONYERS, GA 30012-7291
Phone number: 770-985-4257
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