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Individual

MITCHELL JORDAN TREASTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322
(404) 778-5975
Mailing address
531 ASBURY CIRCLE, SUITE N340, ATLANTA, GA 30322

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8557
GA
363A00000X
Physician Assistant

Other

Enumeration date
08/24/2017
Last updated
10/26/2017
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