Organization
OLYMPIAN SURGICAL ASSISTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON VIRDELL KING (OWNER/DIRECTOR)
(678) 517-3428
Entity
Organization
Contact information
Practice address
55 ATLANTA ST SE STE 204, MARIETTA, GA 30060-1977
(678) 517-3428
(770) 485-1534
Mailing address
PO BOX 81, MARIETTA, GA 30061-0081
(678) 517-3428
(770) 485-1534
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
051517853
GA
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
11/24/2021
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