Rayllensons Itacy, P.A.

NPI #1174804702 in Canton, Georgia

Provider Information

NPI Number: 1174804702
Entity Type: Individual
Name: Rayllensons Itacy, P.A.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: P.A.
Enumeration Date: Sep 9, 2011
Last Updated: Apr 5, 2016

Practice Location

Address: 2020 CUMMING HIGHWAY
Address 2: SUITE 102
City: Canton
State: Georgia
ZIP Code: 30115
Phone: (678) 593-1295

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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