Individual
KRISTINA VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1611
(770) 645-9181
Mailing address
658 HAMLET CIR, GOOSE CREEK, SC 29445-7116
(843) 437-2906
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
24570468
GA
Other
Enumeration date
09/11/2018
Last updated
09/11/2018
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