Healthcare Provider Details

I. General information

NPI: 1346301470
Provider Name (Legal Business Name): COMPLETE HEALTH DIAGNOSTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 04/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SAMMY MCGHEE BLVD SUITE 203
JASPER GA
30143-7711
US

IV. Provider business mailing address

4550 N POINT PKWY SUITE 220
ALPHARETTA GA
30022-2445
US

V. Phone/Fax

Practice location:
  • Phone: 706-253-6553
  • Fax: 706-253-6554
Mailing address:
  • Phone: 770-777-1868
  • Fax: 770-777-1872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT HUNTER
Title or Position: VP OF OPERATIONS
Credential:
Phone: 770-777-1868