Individual
SUSANNAH RENEE HARVELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4340 KINGS WAY, VALDOSTA, GA 31602-6921
(229) 333-9736
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3171
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT003375
GA
363AS0400X
Surgical Physician Assistant
Primary
13141
GA
Other
Enumeration date
04/02/2019
Last updated
06/09/2025
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