Individual
BETHANY JOAN HANSCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1365 CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 712-5742
Mailing address
1290 PLANTERS TRL, GREENSBORO, GA 30642-3981
(706) 224-1837
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9728
GA
Other
Enumeration date
02/06/2020
Last updated
05/12/2020
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