Individual
KATHLEEN M. BOETTCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3970 DEPUTY BILL CANTREL MEMOIRAL RD, CUMMING, GA 30040
(678) 513-2273
(678) 513-8869
Mailing address
3970 DEPUTY BILL CANTREL MEMOIRAL RD, CUMMING, GA 30040
(678) 513-2273
(678) 513-8869
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-00745
NC
363AM0700X
Medical Physician Assistant
1775-023
WI
363AM0700X
Medical Physician Assistant
Primary
6565
GA
Other
Enumeration date
07/21/2005
Last updated
09/02/2016
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