Healthcare Provider Details

I. General information

NPI: 1821567371
Provider Name (Legal Business Name): BREATHE BETTER ALLERGY ASTHMA & SINUS CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 S ENOTA DR NE STE A
GAINESVILLE GA
30501-2439
US

IV. Provider business mailing address

950 S ENOTA DR NE STE A
GAINESVILLE GA
30501-2439
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-0470
  • Fax: 770-536-3031
Mailing address:
  • Phone: 770-536-0470
  • Fax: 770-536-3031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARSHA WILLIAMSON
Title or Position: MANAGER
Credential:
Phone: 706-202-6842