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1524 River Pl Ste 200 Braselton GA 30517-5614 | |
| (404) 355-0743 | |
| (833) 450-5581 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 1524 River Pl Ste 200, Braselton, Georgia |
| Authorized Official Name and Position | Ed Mitchell (CFI) |
| Authorized Official Contact | 4043550743 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2001 Peachtree Rd Ne Ste 705 Atlanta GA 30309-1476 Ph: (404) 355-0743 | 1524 River Pl Ste 200 Braselton GA 30517-5614 Ph: (404) 355-0743 |
| NPI Number | 1033943105 |
|---|---|
| Provider Enumeration Date | 08/29/2024 |
| Last Update Date | 12/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033943105 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
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