Individual
LA TANYA YOUNG THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
555 SUN VALLEY DR, SUITE G1, ROSWELL, GA 30076-5612
(770) 717-7000
Mailing address
PO BOX 993, TUCKER, GA 30085-0993
(404) 429-3100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
002767
GA
Other
Enumeration date
01/29/2011
Last updated
01/29/2011
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