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4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 | |
(470) 545-0275 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | General Practice |
Location | 4935 Jimmy Carter Blvd Ste 360, Norcross, Georgia |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1154940906 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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111N00000X | Chiropractor | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
Provider Name | Kevin T Le |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1851485775 PECOS PAC ID: 2961392337 Enrollment ID: I20201230002307 |
Mailing Address | Practice Location Address |
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4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 Ph: (470) 545-0275 | 4935 Jimmy Carter Blvd Ste 360, Norcross, GA 30093-3536 Ph: (470) 545-0275 |