Individual
LESLIE K ROSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
631 PROFESSIONAL DR, SUITE 450, LAWRENCEVILLE, GA 30046-3367
(770) 963-8030
(770) 339-9577
Mailing address
PO BOX 1190, SUITE 490, LAWRENCEVILLE, GA 30046-1190
(678) 312-5600
(770) 339-2135
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002003
GA
Other
Enumeration date
05/09/2007
Last updated
09/15/2016
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