Individual
JACKLYN LANDRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4546 BARCLAY DR, DUNWOODY, GA 30338-7147
(770) 457-7994
Mailing address
4546 BARCLAY DR, DUNWOODY, GA 30338-7147
(770) 457-7994
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
027125
NY
363A00000X
Physician Assistant
Primary
10563
GA
Other
Enumeration date
09/09/2021
Last updated
09/09/2021
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