Individual
MICHELLE FORRESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1730 LAWRENCEVILLE SUWANEE RD, LAWRENCEVILLE, GA 30043-3507
(770) 338-0089
(770) 338-0091
Mailing address
1730 LAWRENCEVILLE SUWANEE RD, LAWRENCEVILLE, GA 30043-3507
(770) 338-0089
(770) 338-0091
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2052
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2052
STATE LICENSE
GA
Enumeration date
07/28/2010
Last updated
07/28/2010
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