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Individual

TAYLOR LANE BUSH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1405 CLIFTON RD NE, ATLANTA, GA 30322-1060
(404) 785-6400
Mailing address
1405 CLIFTON RD NE, ATLANTA, GA 30322-1060
(404) 785-6400

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11266
GA

Other

Enumeration date
11/08/2022
Last updated
11/08/2022
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