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3615 Marietta Hwy Dallas GA 30157-9472 | |
(866) 607-7334 | |
Not Available |
Full Name | |
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Speciality | Clinic/center |
Location | 3615 Marietta Hwy, Dallas, Georgia |
Authorized Official Name and Position | Rick Vanpelt (COO) |
Authorized Official Contact | 18666077334 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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9 Greenway Plz Suite 2950 Houston TX 77046-0905 Ph: (866) 607-7334 | 3615 Marietta Hwy Dallas GA 30157-9472 Ph: (866) 607-7334 |
NPI Number | 1720251457 |
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Provider Enumeration Date | 04/02/2008 |
Last Update Date | 04/02/2008 |
Identifier | Type | State | Issuer |
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1720251457 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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