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General NPI Number Information
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NPI Number | 1073153409
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Entity Type | Organization
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Legal Business Name | AICA ORTHOPEDICS, P. C.
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 01/14/2020
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY NE STE 305
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City | ATLANTA
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State | GA
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Zip | 30328-4290
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Country | US
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Telephone | 678-701-2225
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Fax | 678-701-2226
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Provider Business Mailing Address
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Address Line | PO BOX 674508
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City | MARIETTA
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State | GA
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Zip | 30006-0076
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Country | US
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Telephone | 678-701-2225
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Fax | 678-701-2226
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Authorized Official
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Title or Position | ACCOUNTANT
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Name | KERI LANIADO
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Credential |
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Telephone | 678-701-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number |
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License Number State |
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