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General NPI Number Information
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NPI Number | 1144626094
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Entity Type | Organization
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Legal Business Name | AB CENTER GROUP CORP LLC
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Dates
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Enumeration Date | 11/05/2014
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Last Update Date | 11/05/2014
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Provider Practice Location Address
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Address Line | 2470 WINDY HILL RD SE SUITE 322A
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 770-256-4421
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Fax |
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Provider Business Mailing Address
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Address Line | 2470 WINDY HILL RD SE SUITE 322A
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City | MARIETTA
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State | GA
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Zip | 30067-8613
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Country | US
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Telephone | 770-256-4421
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALDO BRITO
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Credential |
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Telephone | 770-256-4421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME35733
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License Number State | GA
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