Organization
SUWANEE ANESTHESIA SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WOOD CRNA (CEO/PRESIDENT)
(478) 929-0036
Entity
Organization
Contact information
Practice address
3858 SHADOW LOCH DR, SUWANEE, GA 30024-7003
(478) 929-0036
(478) 929-1744
Mailing address
PO BOX 629, PERRY, GA 31069-0629
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN054969
GA
Other
Enumeration date
06/06/2013
Last updated
06/06/2013
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