MRS. Mary M Domville, P.A.
NPI #1578573820 in Carrollton, Georgia
Provider Information
- NPI Number
- 1578573820
- Entity Type
- Individual
- Name
- MRS. Mary M Domville, P.A.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- P.A.
- Enumeration Date
- Aug 9, 2006
- Last Updated
- Feb 13, 2009
Practice Location
- Address
- 524 DIXIE ST
- City
- Carrollton
- State
- Georgia
- ZIP Code
- 30117-3805
- Phone
- (770) 832-2775
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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