Individual
DR. PRESTON GANTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, SA-C
Contact information
Practice address
367 ATHENS HWY STE 100C, LOGANVILLE, GA 30052-2204
(770) 580-4929
(949) 561-5102
Mailing address
367 ATHENS HWY STE 100C, LOGANVILLE, GA 30052-2204
(770) 580-4929
(949) 561-5102
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34292
FL
Other
Enumeration date
01/29/2018
Last updated
10/03/2023
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