Individual
MARY E MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
165 CLINIC AVE, CARROLLTON, GA 30117-4413
(770) 836-9824
(770) 836-9850
Mailing address
119 AMBULANCE DR STE 202, CARROLLTON, GA 30117-3857
(770) 838-8710
(770) 838-8563
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
GA
Other
Enumeration date
09/08/2017
Last updated
09/08/2017
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