Teresa Boutwell, CST

NPI #1669543203 in Oxford, Georgia

Provider Information

NPI Number
1669543203
Entity Type
Individual
Name
Teresa Boutwell, CST
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Medical
Credential
CST
Enumeration Date
Nov 13, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
70 ASHFORD DR
City
Oxford
State
Georgia
ZIP Code
30054-4648
Phone
(770) 985-4257

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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