Individual
MS. CAROL E., GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSA
Contact information
Practice address
1425 MORIAH TRCE, AUBURN, GA 30011-9637
(404) 936-1378
Mailing address
1425 MORIAH TRCE, AUBURN, GA 30011-9637
(404) 936-1378
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3014
GA
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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