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Individual

MISS FAYE MARIZ LAURIO RAZON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 590-4180
(770) 590-4186
Mailing address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 590-4180
(770) 590-4186

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110008596
VA
363A00000X
Physician Assistant
Primary
10083
GA
363A00000X
Physician Assistant
PA-697
AR
363AS0400X
Surgical Physician Assistant

Other

Enumeration date
12/23/2016
Last updated
04/17/2025
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