Individual
JENISE MARIE SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1150 BROOKSTONE CENTRE PARKWAY, COLUMBUS, GA 31904-4577
(706) 257-4189
(706) 257-4194
Mailing address
835 COGBURN AVENUE, SUITE 250, MARIETTA, GA 30060-1010
(770) 422-8815
(770) 422-8816
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8952
GA
Other
Enumeration date
09/18/2018
Last updated
10/25/2023
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