Individual
MARTINA JANE VIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST NE STE 1600, ATLANTA, GA 30308-2246
(404) 881-1094
(404) 874-1249
Mailing address
550 PEACHTREE ST NE STE 1600, ATLANTA, GA 30308-2246
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9901
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/27/2019
Last updated
07/15/2020
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