Organization · NPI-2

Dominion Orthopaedic Clinic, LLC

Durable Medical Equipment & Medical Supplies · Lilburn, GA

NPI number1841523057
StatusActive
Last updated in NPPESSep 8, 2009

Details

NPI
1841523057
Entity type
Organization (NPI-2)
Legal business name
Dominion Orthopaedic Clinic, LLC
Organization subpart
No
Enumeration date
Sep 8, 2009
Last updated
Sep 8, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
332B00000X Durable Medical Equipment & Medical Supplies––Yes

Practice location

966 Killian Hill Rd Sw
Suite B
Lilburn, GA 30047-3102

Phone 770-455-4009 · Fax 770-455-4065

Mailing address

5555 Peachtree Dunwoody Rd Ne
Suite 215
Atlanta, GA 30342-1703

Phone 770-455-4009 · Fax 770-455-4065

Authorized official

John I Foster
President
7704554009

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