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Individual

MS. CHRISTINA BERRY KNOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
200 E PONCE DE LEON AVE, DECATUR, GA 30030-3466
(404) 377-3436
Mailing address
200 E PONCE DE LEON AVE, DECATUR, GA 30030-3466
(404) 377-3436

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5251
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5251
GEORGIA MEDICAL LICENSE
GA
Enumeration date
02/14/2008
Last updated
08/01/2012
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