Individual
MRS. SANDRA E DECONZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1495 HICKORY FLAT HWY STE 100, CANTON, GA 30115-4266
(678) 341-6360
(678) 626-7900
Mailing address
4300 N POINT PKWY STE 300, ALPHARETTA, GA 30022-4102
(770) 442-1911
(770) 442-0306
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
010356
NY
363AM0700X
Medical Physician Assistant
Primary
8058
GA
Other
Enumeration date
04/25/2006
Last updated
02/24/2026
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