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Individual

LISA HUTCHESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
745 GLYNN ST S, FAYETTEVILLE, GA 30214-2049
(770) 719-5490
(770) 719-3113
Mailing address
4412 AUTUMN GLO CT, DOUGLASVILLE, GA 30135-5097
(404) 610-9998
(770) 719-3113

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2572
GA

Other

Enumeration date
10/31/2013
Last updated
10/31/2013
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