Individual
SANDRA SULLIVAN TYLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
3350 PADDOCKS PKWY, SUWANEE, GA 30024-9119
(678) 735-5300
(678) 735-5305
Mailing address
3350 PADDOCKS PKWY, SUWANEE, GA 30024-9119
(678) 735-5300
(678) 735-5305
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3288
GA
Other
Enumeration date
03/17/2011
Last updated
10/30/2023
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