Individual
JANINE SHEREE REVENIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322
(404) 712-2000
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7637
GA
Other
Enumeration date
07/12/2015
Last updated
08/26/2019
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