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MR. GARY STEVEN KOLLER

Family Health >> Clinical Nurse Specialist >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1205258431

Individual Registrant:
MR. GARY STEVEN KOLLER 
Gender: M
Sole Proprietor

Location and contact information for practice:
76 HOLDER ROAD  LUMPKIN, GA 31815 US
Tel: 229-838-1241  Fax: 229-838-1242

Contact information for business:
79 HOLDER ROAD  LUMPKIN, GA 31815 US
Tel: 229-838-1241  Fax: --

Registration Information:
NPI: 1205258431
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y364SF0001XPhysician Assistants & Advanced Practice Nursing Providers
Clinical Nurse Specialist
Family Health
GARN218792

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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