Individual
MR. JASON ALLEN PEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
150 CLINIC AVE, 101, CARROLLTON, GA 30117-4401
(770) 834-0873
Mailing address
918 CREEK RUN PL, TEMPLE, GA 30179-5435
(678) 458-7631
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
3293
GA
Other
Enumeration date
01/22/2013
Last updated
01/22/2013
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