Individual
HANNAH INGRID BOOMGARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
410 UNIVERSITY PKWY STE 1000, AIKEN, SC 29801-6800
(803) 649-2250
Mailing address
410 UNIVERSITY PKWY STE 1000, AIKEN, SC 29801-6800
(803) 649-2250
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
9506
GA
Other
Enumeration date
10/03/2019
Last updated
05/23/2024
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