Healthcare Provider Details

I. General information

NPI: 1548409089
Provider Name (Legal Business Name): VMP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 09/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 OLD ALABAMA RD STE 220
ROSWELL GA
30076-2272
US

IV. Provider business mailing address

5579 CHAMBLEE DUNWOODY RD STE 110
ATLANTA GA
30338-4128
US

V. Phone/Fax

Practice location:
  • Phone: 404-720-0820
  • Fax: 866-744-5665
Mailing address:
  • Phone: 404-720-0820
  • Fax: 866-744-5665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QG0250X
TaxonomyGenetics Clinic/Center
License Number044706
License Number StateGA

VIII. Authorized Official

Name: FRAN DOUGHERTY KENDALL
Title or Position: GENETICS / MANAGING DIRECTOR
Credential: M.D.
Phone: 404-720-0820