Individual
KRISTIN BOURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309
(404) 605-2800
Mailing address
2001 BUTTERFIELD RD STE 300, DOWNERS GROVE, IL 60515-1069
(630) 725-2730
(844) 205-5691
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
RN008722
GA
Other
Enumeration date
01/25/2018
Last updated
11/13/2018
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