Individual
KIA ELON BURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4327 HUGH HOWELL RD, TUCKER, GA 30084-4739
(678) 800-1279
Mailing address
1275 HIGHWAY 54 W STE 201, FAYETTEVILLE, GA 30214-4538
(678) 688-9285
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8620
GA
Other
Enumeration date
02/07/2019
Last updated
03/21/2023
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