| |
2133 Highway 317, Ste 12-318, Suwanee, GA 30024-2649 | |
(678) 730-6240 | |
(678) 730-0280 |
Full Name | |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 2133 Highway 317, Suwanee, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1811303928 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
208D00000X | General Practice | (* (Not Available)) | Primary |
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
Mailing Address | Practice Location Address |
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1140 Hammond Dr, Suite 110, Bldg K, Atlanta, GA 30328-5338 Ph: (770) 454-8300 | 2133 Highway 317, Ste 12-318, Suwanee, GA 30024-2649 Ph: (678) 730-6240 |