Individual
MRS. AUTUMN DEESE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
401 DIXIE ST, CARROLLTON, GA 30117-3921
(678) 796-0681
(770) 836-8477
Mailing address
401 DIXIE ST, CARROLLTON, GA 30117-3921
(678) 796-0681
(770) 836-8477
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1075178
GA
Other
Enumeration date
03/27/2007
Last updated
08/11/2014
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