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Individual

KATHIE LYNN BRICHANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
465 FORESTDALE DR NE, ATLANTA, GA 30342-2304
(404) 843-2470
(770) 389-4058
Mailing address
465 FORESTDALE DR, ATLANTA, GA 30342
(404) 843-2470
(770) 389-4058

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
049714
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00090243A
GA
Enumeration date
07/27/2006
Last updated
07/08/2007
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