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Individual

JERRY PRICE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2010 BARRINGTON LN, VILLA RICA, GA 30180-6954
(770) 824-7855
Mailing address
2010 BARRINGTON LN, VILLA RICA, GA 30180-6954
(770) 824-7855

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN096358
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121044531A
GA
Enumeration date
04/20/2006
Last updated
09/26/2019
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