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NPI Profile for RYANN SOUTAR in ROSWELL, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X |
| NPI Number | 1093163750 |
|
| Status | Active | |
| Credentials | L.A.P.C. | |
| Entity | Individual | |
| Enumeration date | 06/02/2016 | |
| Last updated | 06/05/2018 - About 8 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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RYANN SOUTAR
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RYANN SOUTAR, L.A.P.C.