| Prohbo - Marietta Llc | |
|
1455 Bells Ferry Rd Suite 100 Marietta GA 30066-6078 | |
| (770) 421-8094 | |
| (770) 421-8096 |
| Full Name | Prohbo - Marietta Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1455 Bells Ferry Rd, Marietta, Georgia |
| Authorized Official Name and Position | Christopher Grant (OWNER) |
| Authorized Official Contact | 7704218094 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prohbo - Marietta Llc 1455 Bells Ferry Rd Suite 100 Marietta GA 30066-6078 Ph: (770) 421-8094 | Prohbo - Marietta Llc 1455 Bells Ferry Rd Suite 100 Marietta GA 30066-6078 Ph: (770) 421-8094 |
| NPI Number | 1417996844 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417996844 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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