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General NPI Number Information
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NPI Number | 1093013385
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Entity Type | Organization
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Legal Business Name | MEDICAL TREATMENT CENTERS OF AMERICA, INC
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 3636 SATELLITE BLVD
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City | DULUTH
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State | GA
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Zip | 30096-4590
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Country | US
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Telephone | 404-448-2012
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Fax | 800-814-3301
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Provider Business Mailing Address
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Address Line | 3636 SATELLITE BLVD
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City | DULUTH
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State | GA
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Zip | 30096-4590
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Country | US
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Telephone | 404-448-2012
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Fax | 800-814-3301
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Authorized Official
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Title or Position | CFO
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Name | MR. OFFER DANAN
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Credential |
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Telephone | 770-695-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | 053868
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License Number State | GA
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