Individual
MRS. BROOKE B. TEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1020 J L WHITE DR STE 160, JASPER, GA 30143-4910
(706) 692-0603
(678) 581-7109
Mailing address
531 ROSELANE ST NW STE 710, MARIETTA, GA 30060-6975
(678) 331-3297
(678) 581-7187
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004814
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427093731
NPI NUMBER
—
05
—
683984257A
—
GA
05
—
683984257B
—
GA
05
—
683984257C
—
GA
Enumeration date
06/19/2006
Last updated
04/17/2019
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