Individual
MS. ANTOINETTE THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5635 PEACHTREE PKWY STE 180, PEACHTREE CORNERS, GA 30092-2823
(470) 938-6670
(678) 272-3144
Mailing address
5635 PEACHTREE PKWY STE 180, PEACHTREE CORNERS, GA 30092-2823
(470) 938-6670
(678) 272-3144
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10250
GA
Other
Enumeration date
07/01/2017
Last updated
01/26/2022
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