Clinic Klinic | |
1750 Powder Springs Rd Sw Ste 510 Marietta GA 30064-4849 | |
(770) 875-8889 | |
Not Available |
Full Name | Clinic Klinic |
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Speciality | Clinic/Center |
Location | 1750 Powder Springs Rd Sw Ste 510, Marietta, Georgia |
Authorized Official Name and Position | Jean M. Lominy (MANAGER) |
Authorized Official Contact | 7708759988 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Clinic Klinic 1750 Powder Springs Rd Sw Ste 510 Marietta GA 30064-4849 Ph: (770) 875-8889 | Clinic Klinic 1750 Powder Springs Rd Sw Ste 510 Marietta GA 30064-4849 Ph: (770) 875-8889 |
NPI Number | 1134793102 |
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Provider Enumeration Date | 05/14/2021 |
Last Update Date | 11/16/2021 |
Medicare PECOS PAC ID | 3173914033 |
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Medicare Enrollment ID | O20220103001883 |
Identifier | Type | State | Issuer |
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1134793102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Manouchka Lominy |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1639302953 PECOS PAC ID: 3274702030 Enrollment ID: I20110811000559 |
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