| Etowahcs, Llc | |
|
200 Leake St Ste 106 Cartersville GA 30120-3562 | |
| (770) 615-0218 | |
| Not Available |
| Full Name | Etowahcs, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 200 Leake St Ste 106, Cartersville, Georgia |
| Authorized Official Name and Position | Christopher M Bruton (OWNER) |
| Authorized Official Contact | 6789860453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Etowahcs, Llc 200 Leake St Ste 106 Cartersville GA 30120-3562 Ph: (770) 615-0218 | Etowahcs, Llc 200 Leake St Ste 106 Cartersville GA 30120-3562 Ph: (770) 615-0218 |
| NPI Number | 1669064390 |
|---|---|
| Provider Enumeration Date | 02/04/2021 |
| Last Update Date | 09/06/2023 |
| Certification Date | 02/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669064390 | NPI | - | NPPES |
| 003229752A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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