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Organization

SPECTRUM SURGICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
FRANK PAUL TANNER CSFA, SA-C (CERTIFIED SURGICAL ASSISTANT)
(678) 516-2119
Entity
Organization

Contact information

Practice address
3142 HIGHWAY 278 NW # 135, COVINGTON, GA 30014-2304
(678) 516-2119
Mailing address
3142 HIGHWAY 278 NW # 135, COVINGTON, GA 30014-2304
(678) 516-2119

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
03/03/2020
Last updated
03/03/2020
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