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NPI 1043115090

NPI 1043115090 : ONE LUCKY SEVEN CORPORATION : HAHIRA, GA

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General NPI Number Information
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    NPI Number           |    1043115090
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    Entity Type          |    Organization 
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    Legal Business Name  |    ONE LUCKY SEVEN CORPORATION 
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Dates
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    Enumeration Date     |    10/09/2026
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    Last Update Date     |    10/09/2026
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Provider Practice Location Address
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    Address Line         |    505 E MAIN ST APT D 
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    City                 |    HAHIRA
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    State                |    GA
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    Zip                  |    31632-1273
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    Country              |    US
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    Telephone            |    678-670-9458
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    505 E MAIN ST APT D 
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    City                 |    HAHIRA
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    State                |    GA
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    Zip                  |    31632-1273
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    Country              |    US
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    Telephone            |    678-670-9458
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     SAFDAR  HUSSAIN 
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    Credential           |    DO
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    Telephone            |    678-670-9458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    
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    License Number State |    NULL
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