Individual
AMY THEOBALD COLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3400C OLD MILTON PKWY STE 270, ALPHARETTA, GA 30005-4438
(770) 442-1911
Mailing address
3400 OLD MILTON PKWY STE C270, ALPHARETTA, GA 30005-4414
(704) 421-9117
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
9156
GA
Other
Enumeration date
02/14/2019
Last updated
08/27/2020
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