Individual
CARLOS A VELAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 278-2105
(865) 291-3228
Mailing address
26 LANDERS RD NE, RYDAL, GA 30171-1657
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004216
GA
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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