Individual
AUTUMN VENTURELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
19 COACH LEE HILL BLVD, STATESBORO, GA 30458-4700
(912) 662-6501
Mailing address
19 COACH LEE HILL BLVD, STATESBORO, GA 30458-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11025
GA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/07/2021
Last updated
01/28/2023
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