Organization
PROSOURCE SURGICAL ASSISTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCELLA ANN TOWNSEND CSA (CERTIFIED SURGICAL ASSISTANT)
(912) 604-0905
Entity
Organization
Contact information
Practice address
2414 CALIBRE CREEK PKWY, ROSWELL, GA 30076-4540
(912) 604-0905
(770) 558-4499
Mailing address
PO BOX 768873, ROSWELL, GA 30076-8211
(912) 604-0905
(678) 243-5735
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/04/2017
Last updated
07/31/2023
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