Individual
LEAH MARIE GUMUCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1305 JENNINGS MILL RD STE 290A, WATKINSVILLE, GA 30677-7238
(706) 552-1840
(706) 552-1849
Mailing address
4500 FOREST DR STE A, COLUMBIA, SC 29206-3105
(803) 738-9522
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007513
GA
Other
Enumeration date
12/29/2011
Last updated
02/14/2018
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