Individual
ANDRE GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
217 BROOKHAVEN CT, ACWORTH, GA 30102-2190
(770) 985-4257
(770) 985-4258
Mailing address
217 BROOKHAVEN CT, ACWORTH, GA 30102-2190
(770) 985-4257
(770) 985-4258
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2970
GA
Other
Enumeration date
05/26/2011
Last updated
05/26/2011
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