Individual
MR. ERIC IRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CERT. FIRST ASSIST
Contact information
Practice address
859 ECTOR CHASE NW, KENNESAW, GA 30152-4788
(770) 614-4177
(770) 427-6396
Mailing address
PO BOX 3235, MARIETTA, GA 30061-3235
(770) 614-4711
(770) 427-6396
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
CSA 2852 CERTIFICATE
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
582625656
TAX ID
GA
Enumeration date
01/17/2007
Last updated
07/08/2007
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