Organization
MARIETTA PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARIE BOCKHORST (PRACTICE ADMIN)
(770) 425-0118
Entity
Organization
Contact information
Practice address
149 TOWNE LAKE PKWY, WOODSTOCK, GA 30188-4859
(678) 494-2380
(678) 494-2379
Mailing address
149 TOWNE LAKE PKWY, WOODSTOCK, GA 30188-4859
(678) 494-2380
(678) 494-2379
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
GA
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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