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Individual

MR. RICHARD BRIAN PRATER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
270 CHASTAIN RD NW, KENNESAW, GA 30144-3012
(770) 421-8005
(770) 424-5662
Mailing address
270 CHASTAIN RD NW, KENNESAW, GA 30144-3012
(770) 421-8005
(770) 424-5662

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005499
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
442741884A
GA
05
442741884B
GA
Enumeration date
04/02/2008
Last updated
02/09/2009
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