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Individual

BRIAN WEST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CAA

Contact information

Practice address
1300 RIDENOUR BLVD NW, KENNESAW, GA 30152-4501
(770) 702-1806
Mailing address
1300 RIDENOUR BLVD NW, KENNESAW, GA 30152-4501

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
00002262
OH
367H00000X
Anesthesiologist Assistant
Primary
8126
GA
367H00000X
Anesthesiologist Assistant

Other

Enumeration date
08/13/2015
Last updated
12/28/2022
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