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General NPI Number Information
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NPI Number | 1174045942
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Entity Type | Organization
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Legal Business Name | SONOMILLIONS LLC
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Dates
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Enumeration Date | 07/12/2017
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Last Update Date | 07/12/2017
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Provider Practice Location Address
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Address Line | 1980 RIDGESTONE RUN SW
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City | MARIETTA
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State | GA
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Zip | 30008-4088
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Country | US
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Telephone | 404-449-8216
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Fax |
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Provider Business Mailing Address
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Address Line | 2136 SHOOP CT SE
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City | SMYRNA
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State | GA
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Zip | 30080-6996
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Country | US
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Telephone | 404-723-7662
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BRIAN J BOYKINS
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Credential | CVT
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Telephone | 404-723-7662
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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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