Individual
ADAM ELLIS RIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6195
Mailing address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 272-6195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10269
GA
Other
Enumeration date
09/26/2019
Last updated
03/05/2021
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