Individual
MS. JENNIFER LEIGH CARLQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1700 HOSPITAL SOUTH DR STE 409, AUSTELL, GA 30106-8159
(770) 732-9100
(678) 819-0359
Mailing address
1700 HOSPITAL SOUTH DR STE 409, AUSTELL, GA 30106-8159
(770) 732-9100
(678) 819-0359
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12028
GA
363A00000X
Physician Assistant
PA 19294
CA
Other
Enumeration date
08/13/2007
Last updated
05/17/2024
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