Organization
REGAIL'S ENTERPRISES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GEORGETTE ANTHONY (ASSISTANT)
(770) 630-8997
Entity
Organization
Contact information
Practice address
5116 VERBENA DR NW, ACWORTH, GA 30102-6923
(770) 630-8997
Mailing address
5116 VERBENA DR NW, ACWORTH, GA 30102-6923
(770) 630-8997
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
11/04/2015
Last updated
11/04/2015
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