Individual
JACQUELINE M RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
631 PROFESSIONAL DR STE 170, LAWRENCEVILLE, GA 30046-3392
(678) 312-2663
Mailing address
1973 BOYD TRACE LN NW, ATLANTA, GA 30318-4471
(859) 684-5250
(859) 684-5250
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10160
GA
363AS0400X
Surgical Physician Assistant
PA9112791
FL
Other
Enumeration date
11/22/2019
Last updated
04/09/2025
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