TOM M FAZLOLLAH

ATLANTA, GA
NPI1942296660
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: GA  RN047276)
Enumeration Date2005-09-27
Last Update Date2007-07-08
Business Address
-- TOM M FAZLOLLAH CRNA
1000 JOHNSON FERRY RD NE
ATLANTA, GA 30342-1606
Phone number: 770-645-9181
Mailing Address
-- TOM M FAZLOLLAH CRNA
200 MANSELL CT E ATTN: CREDENTIALING DEPT., SUITE 105
ROSWELL, GA 30076-4856
Phone number: 770-645-9181
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