| Eagle Drive Family Medicine Pc | |
|
1816 Eagle Dr Suite 200-b Woodstock GA 30189-8272 | |
| (678) 445-5995 | |
| Not Available |
| Full Name | Eagle Drive Family Medicine Pc |
|---|---|
| Speciality | General Practice |
| Location | 1816 Eagle Dr, Woodstock, Georgia |
| Authorized Official Name and Position | Richard Leon Manrique (PRESIDENT) |
| Authorized Official Contact | 6784455995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagle Drive Family Medicine Pc 1816 Eagle Dr Suite 200-b Woodstock GA 30189-8272 Ph: (678) 445-5995 | Eagle Drive Family Medicine Pc 1816 Eagle Dr Suite 200-b Woodstock GA 30189-8272 Ph: (678) 445-5995 |
| NPI Number | 1750514295 |
|---|---|
| Provider Enumeration Date | 09/01/2009 |
| Last Update Date | 01/25/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750514295 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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