Individual
VITIA ANGELA PACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
49 HOSIERY MILL RD STE 124, DALLAS, GA 30157-1688
(770) 443-6111
Mailing address
49 HOSIERY MILL RD STE 124, DALLAS, GA 30157-1688
(770) 443-6111
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
—
—
363A00000X
Physician Assistant
Primary
PA9106235
FL
Other
Enumeration date
04/18/2007
Last updated
04/29/2025
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