| Georgia Advanced Healthcare, Llc | |
|
205 Waleska Rd Suite C Canton GA 30114-2493 | |
| (770) 265-7718 | |
| (770) 345-4591 |
| Full Name | Georgia Advanced Healthcare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 205 Waleska Rd, Canton, Georgia |
| Authorized Official Name and Position | William Paul Early (OWNER) |
| Authorized Official Contact | 7702657718 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Georgia Advanced Healthcare, Llc 205 Waleska Rd Suite C Canton GA 30114-2493 Ph: (770) 265-7718 | Georgia Advanced Healthcare, Llc 205 Waleska Rd Suite C Canton GA 30114-2493 Ph: (770) 265-7718 |
| NPI Number | 1568836278 |
|---|---|
| Provider Enumeration Date | 11/18/2015 |
| Last Update Date | 11/18/2015 |
| Medicare PECOS PAC ID | 2264737923 |
|---|---|
| Medicare Enrollment ID | O20160218001068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568836278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 111N00000X (Georgia) | Primary |
| Provider Name | William Paul Early |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1881994077 PECOS PAC ID: 0446434153 Enrollment ID: I20110405000039 |
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