Individual
MR. CHAD STOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2713 MARIETTA HIGHWAY, SUITE 122, DALLAS, GA 30157
(770) 505-3162
(770) 948-9126
Mailing address
915 THORNTON ROAD, LITHIA SPRINGS, GA 30122
(770) 739-9292
(770) 948-9126
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004763
GA
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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