Individual
GAIL VAN DER WANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(770) 645-9181
Mailing address
3155 N POINT PKWY STE F100, ALPHARETTA, GA 30005-5495
(770) 645-9181
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
008111
GA
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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