Organization
NWELITE SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TELITA ANTHONY (CERTIFIED FIRST SURGICAL ASSIST)
(770) 905-3089
Entity
Organization
Contact information
Practice address
2205 THICKET CT NW, ACWORTH, GA 30102-7955
(770) 905-3089
(770) 675-3716
Mailing address
PO BOX 492, KENNESAW, GA 30156-0492
(770) 905-3089
(770) 675-3716
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/11/2015
Last updated
02/26/2016
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