Individual
AVERY LOUISE ELLOWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2750 OWENS RD SW, CONYERS, GA 30094-3991
(678) 413-4644
Mailing address
2750 OWENS RD SW, CONYERS, GA 30094-3991
(678) 413-4644
(470) 705-0074
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
11573
GA
Other
Enumeration date
09/20/2021
Last updated
12/03/2024
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