Individual
MS. RESHMA THANKAM BENNY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1411 LANEY WALKER BLVD, AUGUSTA, GA 30912-0002
(706) 721-6744
Mailing address
1723 CHESIL DR, AUGUSTA, GA 30907-4361
(706) 361-1995
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10084
GA
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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