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Individual

SARAH B. BOLICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
270 CHASTAIN RD NW, KENNESAW, GA 30144-3012
(770) 421-8005
(770) 424-5662
Mailing address
270 CHASTAIN RD NW, KENNESAW, GA 30144-3012
(770) 421-8005
(770) 424-5662

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004335
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
842696858C
GA
05
842696858D
GA
05
842696858E
GA
05
842696858F
GA
05
842696858G
GA
Enumeration date
02/22/2006
Last updated
12/10/2012
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