Individual
KELLY L JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3345 HIGHWAY 34 E, SUITE 101, SHARPSBURG, GA 30277-3563
(770) 502-8005
(770) 502-1825
Mailing address
1065 JODECO RD, STOCKBRIDGE, GA 30281-4953
(678) 284-6300
(678) 284-6282
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004042
GA
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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