Individual
KERI L MINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 PROFESSIONAL PARK, SUITE 310, CARROLLTON, GA 30117-3874
(770) 812-5902
(770) 812-5903
Mailing address
69 JESSE HILL JR DR SE, ROOM 314A, ATLANTA, GA 30303-3033
(404) 251-8916
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005947
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005947
GA. LICENSE
GA
Enumeration date
10/21/2010
Last updated
08/13/2014
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