Individual
KAIA LOWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6572 RIVER PARK DR, #101, RIVERDALE, GA 30274-2214
(770) 996-6699
(770) 692-2669
Mailing address
6572 RIVER PARK DR, #101, RIVERDALE, GA 30274-2214
(770) 996-6699
(770) 692-2669
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004319
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004319
STATE LICENSE
GA
Enumeration date
01/02/2007
Last updated
07/08/2007
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