| Mobile Mini Clinic | |
|
2225 Prickly Pear Walk Lawrenceville GA 30043-6344 | |
| (470) 207-1866 | |
| Not Available |
| Full Name | Mobile Mini Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 2225 Prickly Pear Walk, Lawrenceville, Georgia |
| Authorized Official Name and Position | Taheerah Demby (CEO) |
| Authorized Official Contact | 4702071866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Mini Clinic 2225 Prickly Pear Walk Lawrenceville GA 30043-6344 Ph: (219) 201-3215 | Mobile Mini Clinic 2225 Prickly Pear Walk Lawrenceville GA 30043-6344 Ph: (470) 207-1866 |
| NPI Number | 1194362699 |
|---|---|
| Provider Enumeration Date | 12/03/2019 |
| Last Update Date | 07/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194362699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 261QH0100X | Clinic/center - Health Service | (* (Not Available)) | Secondary |
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