Organization · NPI-2

Advanced Laparoscopic Surgical, LLC

Surgery · Lithonia, GA

NPI number1831409838
StatusActive
Last updated in NPPESOct 12, 2010

Details

NPI
1831409838
Entity type
Organization (NPI-2)
Legal business name
Advanced Laparoscopic Surgical, LLC
Organization subpart
No
Enumeration date
Oct 12, 2010
Last updated
Oct 12, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery051545GAYes

Practice location

5910 Hillandale Dr Ste 209
Lithonia, GA 30058-1880

Phone 404-294-0257 · Fax 678-252-6675

Mailing address

Po Box 102294
Atlanta, GA 30368-2294

Phone 404-294-0257 · Fax 678-252-6675

Authorized official

Andre Scott
Owner
4046719556

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