Healthcare Provider Details

I. General information

NPI: 1942464375
Provider Name (Legal Business Name): PERIMETER HEALTH CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 07/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 SPRING RD #116
ATLANTA GA
30339
US

IV. Provider business mailing address

PO BOX 500067
ATLANTA GA
31150
US

V. Phone/Fax

Practice location:
  • Phone: 678-217-7700
  • Fax: 678-271-7701
Mailing address:
  • Phone: 678-701-2225
  • Fax: 678-701-2226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICIA BENTON
Title or Position: CEO
Credential: MD
Phone: 678-701-2225