Pact Atlanta, LLC
Clinic/Center, Medical Specialty in Decatur, GA. Organization (NPI-2).
NPI number1114092202
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1114092202
- Entity type
- Organization (NPI-2)
- Legal business name
- Pact Atlanta, LLC
- Organization subpart
- No
- Enumeration date
- Nov 22, 2006
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM2500X | Clinic/Center, Medical Specialty | 036495 | GA | Yes |
Practice location
465 Winn Way Ste 221Decatur, GA 30030-1723
Phone 404-292-3810 · Fax 404-292-3848
Mailing address
465 Winn Way Ste 221Decatur, GA 30030-1723
Phone 404-292-3810 · Fax 404-292-3848
Authorized official
Todd M Antin
Ceo
4042923810
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