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General NPI Number Information
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NPI Number | 1093482903
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Entity Type | Organization
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Legal Business Name | LIFEHOPE MOBILE MEDICAL
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Dates
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Enumeration Date | 08/27/2021
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Last Update Date | 08/27/2021
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Provider Practice Location Address
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Address Line | 11680 GREAT OAKS WAY STE 300
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City | ALPHARETTA
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State | GA
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Zip | 30022-2459
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Country | US
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Telephone | 404-255-6358
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 PRESTON RIDGE RD STE 380
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City | ALPHARETTA
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State | GA
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Zip | 30005-4596
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | SCOTT HONAN
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Credential |
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Telephone | 404-255-6358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number |
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License Number State |
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