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JACQUELINE LYDIA DIFELICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
61 WHITCHER ST NE STE 1100, MARIETTA, GA 30060-1177
(770) 422-3290
Mailing address
61 WHITCHER ST NE STE 1100, MARIETTA, GA 30060-1177
(770) 422-3290

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12643
GA

Other

Enumeration date
12/05/2024
Last updated
12/05/2024
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