Individual
MR. BRENT J FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CSFA
Contact information
Practice address
1240 JESSE JEWELL PKWY SE STE 360, GAINESVILLE, GA 30501-3861
(770) 534-9420
Mailing address
3497 ABBEY WAY, GAINESVILLE, GA 30507-5045
(770) 530-2732
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
GA
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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