South Fulton Regenerative Medicine And Physical Rehabilitation
General Practice in Atlanta, GA. Organization (NPI-2).
NPI number1750996302
StatusActive
Last updated in NPPESSep 10, 2020
Details
- NPI
- 1750996302
- Entity type
- Organization (NPI-2)
- Legal business name
- South Fulton Regenerative Medicine And Physical Rehabilitation
- Organization subpart
- No
- Enumeration date
- Sep 10, 2020
- Certification date
- Sep 10, 2020
- Last updated
- Sep 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
Practice location
5835 Campbellton Rd Sw Ste 204Atlanta, GA 30331-8014
Phone 404-349-3601
Mailing address
5835 Campbellton Rd Sw Ste 204Atlanta, GA 30331-8014
Phone 404-349-3601
Authorized official
Shawn G Jones
Owner
4043493601
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