Individual
MRS. PATRICIA J EUBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
631 PROFESSIONAL DR, STE 360, LAWRENCEVILLE, GA 30046-3367
(770) 962-4895
(770) 962-4792
Mailing address
631 PROFESSIONAL DR, STE 360, LAWRENCEVILLE, GA 30046-3367
(770) 962-4895
(770) 962-4792
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2284
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
616293304A
—
GA
Enumeration date
11/20/2006
Last updated
01/10/2012
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