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Individual

CHRISTIE RARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
581 VIRGINIA AVE, SUWANEE, GA 30024-2210
(404) 395-4228
Mailing address
581 VIRGINIA AVE, SUWANEE, GA 30024-2210
(404) 395-4228

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT007792
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
966327739A
GA
Enumeration date
11/13/2006
Last updated
09/28/2011
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