| |
2360 Towne Lake Pkwy Ste 104, Woodstock, GA 30189-5576 | |
(770) 516-7477 | |
(770) 516-7493 |
Full Name | |
---|---|
Type | Facility |
Speciality | General Practice |
Location | 2360 Towne Lake Pkwy Ste 104, Woodstock, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578974390 | 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 |
---|---|
2133 Highway 317 Ste 12-318, Suwanee, GA 30024-2649 Ph: (678) 730-6240 | 2360 Towne Lake Pkwy Ste 104, Woodstock, GA 30189-5576 Ph: (770) 516-7477 |