Individual
KENZIE DITTMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
850 CHARLES HARDY PKWY, DALLAS, GA 30157-3163
(770) 336-8888
Mailing address
1502 N AMANDA CIR NE, ATLANTA, GA 30329-3320
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/21/2025
Last updated
01/29/2026
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