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Individual

ANNETTE RAQUEL MCMICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CSFA

Contact information

Practice address
1182 OLD PENDERGRASS RD, JEFFERSON, GA 30549-2763
(706) 870-9366
Mailing address
1182 OLD PENDERGRASS RD, JEFFERSON, GA 30549-2763
(706) 870-9366

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
100264350
GA

Other

Enumeration date
12/20/2023
Last updated
12/20/2023
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