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Organization

OASIS SURGICAL ASSISTANTS L.L.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
HERBERT LOUIS COUSIN JR. CSA (OWNER)
(770) 875-1243
Entity
Organization

Contact information

Practice address
6110 CEDARCREST RD NW, SUITE 350-184, ACWORTH, GA 30101-9539
(770) 875-1243
(404) 464-0781
Mailing address
6110 CEDARCREST RD NW, SUITE 350-184, ACWORTH, GA 30101-9539
(770) 875-1243
(404) 464-0781

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
4019
GA

Other

Enumeration date
01/13/2014
Last updated
01/13/2014
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