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MRS. DIANA SPOCK ADEBULEHIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
1014 SYCAMORE DR, STE. B, DECATUR, GA 30030-1644
(404) 299-1700
(404) 299-1616
Mailing address
200 IVY GLEN CIR, AVONDALE ESTATES, GA 30002-1766
(404) 550-5590
(404) 299-1616

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
004458
GA

Other

Enumeration date
11/06/2006
Last updated
07/09/2007
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