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Individual

MRS. TOREY CHARLISE DAVIS-BOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SA-C, CST

Contact information

Practice address
3105 ROME CT SW, MARIETTA, GA 30064-4423
(317) 664-0771
Mailing address
3105 ROME CT SW, MARIETTA, GA 30064-4423
(317) 664-0771

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
18-399
GA

Other

Enumeration date
12/27/2019
Last updated
02/21/2022
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