Berta E Booth, PA

NPI #1609183805 in Riverdale, Georgia

Provider Information

NPI Number: 1609183805
Entity Type: Individual
Name: Berta E Booth, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Sep 9, 2010
Last Updated: Nov 23, 2015

Practice Location

Address: 6572 RIVER PARK DR STE 101
City: Riverdale
State: Georgia
ZIP Code: 30274-2214
Phone: (770) 996-6699

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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