Individual
TINA DEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4245 JOHNS CREEK PKWY, SUITE D, SUWANEE, GA 30024-9121
(770) 495-3820
Mailing address
306 PEEKSKILL CT, DULUTH, GA 30097-1936
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/19/2013
Last updated
04/19/2013
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