Individual
OMOTOLA OMOLAYO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
652 BELLEMEADE AVE NW, ATLANTA, GA 30318-3102
(678) 705-8166
Mailing address
652 BELLEMEADE AVE NW, ATLANTA, GA 30318-3102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10744
GA
Other
Enumeration date
03/07/2022
Last updated
04/11/2024
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