Individual
MATTEA KRASICKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
400 TOWER RD NE STE 200, MARIETTA, GA 30060-9412
(770) 422-1372
(770) 999-2488
Mailing address
400 TOWER RD NE STE 200, MARIETTA, GA 30060-9412
(770) 422-1372
(770) 999-2488
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11244
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/18/2022
Last updated
02/20/2023
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