Individual
MRS. AMANDA KATHRYN KLOSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
21 ORTHO LN, ATLANTA, GA 30329-2315
(404) 778-3350
Mailing address
21 ORTHO LN, ATLANTA, GA 30329-2315
(404) 778-3350
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
3264
GA
363AS0400X
Surgical Physician Assistant
Primary
3264
GA
364SM0705X
Medical-Surgical Clinical Nurse Specialist
003264
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100000985A
—
GA
Enumeration date
08/17/2005
Last updated
02/22/2022
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