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1982693024
RICHARD M PROENZA
VIDALIA, GA
NPI
1982693024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: GA 004304)
Enumeration Date
2005-10-20
Last Update Date
2013-10-03
Business Address
-- RICHARD M PROENZA PA-C
3301 E 1ST ST SUITE A
VIDALIA, GA 30474-8674
Phone number: 912-537-4411
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Mailing Address
-- RICHARD M PROENZA PA-C
3301 E 1ST ST SUITE A
VIDALIA, GA 30474-8674
Phone number: 912-537-4411
Copy
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