Individual
SARA ELIZABETH BOBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15 REINHARDT COLLEGE PKWY STE 100, CANTON, GA 30114-5259
(770) 704-6988
Mailing address
122 OAKVIEW PSGE, CANTON, GA 30114-1800
(678) 389-0858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN269980
GA
207R00000X
Internal Medicine Physician
RN269980
GA
363L00000X
Nurse Practitioner
Primary
RN269980
GA
Other
Enumeration date
08/25/2023
Last updated
12/01/2023
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