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General NPI Number Information
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NPI Number | 1063942886
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Entity Type | Organization
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Legal Business Name | ATLANTA HOLISTIC HEALTH CENTER
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 320 WINN WAY STE 101
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City | DECATUR
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State | GA
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Zip | 30030-2106
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Country | US
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Telephone | 404-697-6886
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Fax |
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Provider Business Mailing Address
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Address Line | 455 VILLA PLACE CT
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City | TUCKER
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State | GA
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Zip | 30084-1958
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Country | US
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Telephone | 404-697-6886
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Fax | 470-823-4926
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Authorized Official
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Title or Position | MANAGER
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Name | LI JIANG
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Credential |
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Telephone | 404-697-6886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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