Individual
MARK E LOISELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
515 LAKEWOOD CT, CANTON, GA 30114-6694
(770) 361-0034
Mailing address
515 LAKEWOOD CT, CANTON, GA 30114-6694
(770) 361-0034
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
200838
—
246ZS0410X
Surgical Technologist
—
—
Other
Enumeration date
08/03/2011
Last updated
08/06/2025
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