Individual
GABRIELLE MELISSA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
227 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 720-7733
Mailing address
227 RIVERSTONE DR, CANTON, GA 30114-5256
(770) 720-7733
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110-005800
VA
363AM0700X
Medical Physician Assistant
Primary
10986
GA
Other
Enumeration date
06/20/2017
Last updated
12/21/2023
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