Individual
MARIE L WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1502 W 3RD ST, JACKSON, GA 30233-1979
(678) 774-0430
(770) 775-3410
Mailing address
1502 W 3RD ST, JACKSON, GA 30233-1979
(678) 774-0430
(770) 775-3410
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005122
GA
Other
Enumeration date
10/09/2008
Last updated
02/03/2009
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