Individual
KELLIE ELISE WYDRINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
980 JOHNSON FERRY RD STE 820, ATLANTA, GA 30342-1608
(404) 252-9307
(404) 252-5839
Mailing address
980 JOHNSON FERRY RD STE 820, ATLANTA, GA 30342-1608
(404) 252-9307
(404) 252-5839
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12383
GA
Other
Enumeration date
05/04/2024
Last updated
07/12/2024
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