| Progressive Healthcare Of Gwinnett Llc | |
|
670 Indian Trail Lilburn Rd Nw Lilburn GA 30047-1716 | |
| (770) 925-0088 | |
| (770) 925-3711 |
| Full Name | Progressive Healthcare Of Gwinnett Llc |
|---|---|
| Speciality | General Practice |
| Location | 670 Indian Trail Lilburn Rd Nw, Lilburn, Georgia |
| Authorized Official Name and Position | Dennis Lew Rattiner (OWNER) |
| Authorized Official Contact | 4045792225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Progressive Healthcare Of Gwinnett Llc 670 Indian Trail Lilburn Rd Nw Lilburn GA 30047-1716 Ph: (770) 925-0088 | Progressive Healthcare Of Gwinnett Llc 670 Indian Trail Lilburn Rd Nw Lilburn GA 30047-1716 Ph: (770) 925-0088 |
| NPI Number | 1174892392 |
|---|---|
| Provider Enumeration Date | 12/16/2011 |
| Last Update Date | 12/16/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174892392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 37957 (Georgia) | Primary |
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