Individual
ALLISON BRUCE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5669 PEACHTREE DUNWOODY RD NE, SUITE 315, ATLANTA, GA 30342-1786
(678) 843-6400
(678) 843-6405
Mailing address
1838 AMERICAN WAY, LAWRENCEVILLE, GA 30043-6611
(770) 995-7622
(770) 995-7854
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004111
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003120064A
—
GA
05
—
003120064B
—
GA
05
—
003120064C
—
GA
Enumeration date
10/27/2011
Last updated
03/21/2013
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