Organization
CITY WIDE ANESTHESIA ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH DAVID STANLEY CRNA (MANAGING MEMBER)
(706) 207-5407
Entity
Organization
Contact information
Practice address
1720 EPPS BRIDGE PKWY, SUITE 108-382, ATHENS, GA 30606-6132
(706) 207-5407
Mailing address
1720 EPPS BRIDGE PKWY, SUITE 108-382, ATHENS, GA 30606-6132
(706) 207-5407
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
GA
Other
Enumeration date
01/18/2009
Last updated
01/18/2009
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