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General NPI Number Information
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NPI Number | 1053684043
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Entity Type | Organization
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Legal Business Name | A B MEDICAL INVESTMENT-LLC
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Dates
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Enumeration Date | 02/22/2012
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Last Update Date | 02/22/2012
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Provider Practice Location Address
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Address Line | 1773 SWEETWATER ST
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City | AUSTELL
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State | GA
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Zip | 30106-3294
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Country | US
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Telephone | 770-846-2238
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Fax |
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Provider Business Mailing Address
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Address Line | 3695F CASCADE RD SW STE 2179
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City | ATLANTA
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State | GA
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Zip | 30331-2105
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Country | US
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Telephone | 770-846-2239
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Fax |
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Authorized Official
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Title or Position | PRES
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Name | DR. ROMIE ROLAND
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Credential | MD
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Telephone | 770-845-2238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State | GA
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