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General NPI Number Information
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NPI Number | 1356182893
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Entity Type | Individual
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Provider Name | SCOTT BAMBY
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Gender | Male
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/10/2024
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Provider Practice Location Address
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Address Line | 730 PEACHTREE ST NE STE 570
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City | ATLANTA
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State | GA
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Zip | 30308-1244
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Country | US
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Telephone | 623-203-1321
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Fax |
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Provider Business Mailing Address
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Address Line | 1441 WOODMONT LN NW STE 193
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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