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Organization

SOUTHERN SURGICAL ASSISTANTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSEPH HENRY KANCLERZ ARNP, RNFA (OWNER)
(678) 591-8644
Entity
Organization

Contact information

Practice address
5742 ALLEE WAY, BRASELTON, GA 30517
(678) 591-8344
(770) 965-3365
Mailing address
PO BOX 7042, CHESTNUT MOUNTAIN, GA 30502-0042
(678) 591-8344
(770) 965-3365

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary

Other

Enumeration date
04/28/2008
Last updated
11/28/2018
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