Individual
CRYSTAL SUITS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
1223 FRIENDSHIP RD STE 110, BRASELTON, GA 30517-5637
(678) 210-2180
Mailing address
8210 NOBLE VINES DR, BUFORD, GA 30519-6145
(706) 244-5050
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
17-566
GA
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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