Individual
MR. JONATHAN PACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT-I
Contact information
Practice address
4683 REDAN RD, STONE MOUNTAIN, GA 30083
(678) 492-5466
Mailing address
4683 REDAN RD, STONE MOUNTAIN, GA 30083
(678) 492-5466
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
Primary
I042897
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
I042897
NA
GA
Enumeration date
04/04/2019
Last updated
04/04/2019
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