Jill Rae Mattingly, PA-C, MMSC

NPI #1770795361 in Tucker, Georgia

Provider Information

NPI Number: 1770795361
Entity Type: Individual
Name: Jill Rae Mattingly, PA-C, MMSC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C, MMSC
Enumeration Date: May 4, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 4500 HUGH HOWELL RD
Address 2: SUITE 340
City: Tucker
State: Georgia
ZIP Code: 30084-4723
Phone: (678) 534-1715

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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