Individual
MR. CARLOS JUAN GARCIA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
1404 RIVER PL STE 401, BRASELTON, GA 30517-5600
(770) 848-6190
(770) 848-5367
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
(770) 219-8440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
008400
GA
363AS0400X
Surgical Physician Assistant
Primary
008400
GA
Other
Enumeration date
05/01/2017
Last updated
12/04/2018
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