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5836 Buford Hwy Ste C Norcross GA 30071-2581 | |
| (770) 734-9920 | |
| (770) 734-9115 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Public Health, Federal |
| Location | 5836 Buford Hwy Ste C, Norcross, Georgia |
| Authorized Official Name and Position | Rodrigo Parra (OWNER, CFO) |
| Authorized Official Contact | 6783333498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5717 Allee Way Braselton GA 30517-6200 Ph: (678) 333-3498 | 5836 Buford Hwy Ste C Norcross GA 30071-2581 Ph: (770) 734-9920 |
| NPI Number | 1598427130 |
|---|---|
| Provider Enumeration Date | 10/11/2021 |
| Last Update Date | 01/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598427130 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0904X | Clinic/center - Public Health, Federal | (* (Not Available)) | Primary |
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