Individual
MS. EBONI CHAUNTAE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
400 TOWER RD NE STE 200, MARIETTA, GA 30060-9412
(770) 514-7550
Mailing address
400 TOWER RD NE STE 200, MARIETTA, GA 30060-9412
(770) 514-7550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007152
GA
Other
Enumeration date
04/14/2014
Last updated
03/07/2018
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