Individual
SHIRLEY EPHRAIM BASSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
55 WHITCHER STREET, SUITE 160, MARIETTA, GA 30060
(770) 422-1372
Mailing address
2187 CHEROKEE VALLEY CIR, LITHONIA, GA 30058-5365
(404) 285-4380
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6593
GA
Other
Enumeration date
10/16/2012
Last updated
10/16/2012
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