Individual
CAROLINA JUNE KVIETKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1110 W PEACHTREE ST NW STE 830, ATLANTA, GA 30309-3609
(770) 442-1911
(404) 685-3632
Mailing address
3400C OLD MILTON PKWY STE 270, ALPHARETTA, GA 30005-4438
(770) 442-1911
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9867
GA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/24/2020
Last updated
05/10/2024
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