Individual
BRIAN PALM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1000 MEDICAL CENTER BLVD, LAWRENCEVILLE, GA 30046-7694
(678) 312-3356
Mailing address
PO BOX 153, WOODSTOCK, GA 30188-0153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007095
GA
Other
Enumeration date
02/17/2014
Last updated
07/01/2015
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