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General NPI Number Information
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NPI Number | 1386919280
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Entity Type | Organization
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Legal Business Name | DOCTORS CHOICE ADVANTAGE MEDICAL AND WEIGHT MANAGEMENT SERVICES
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Dates
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Enumeration Date | 03/12/2012
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Last Update Date | 03/12/2012
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Provider Practice Location Address
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Address Line | 960 HOLCOMB BRIDGE RD SUITE 2-5
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City | ROSWELL
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State | GA
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Zip | 30076-1963
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Country | US
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Telephone | 770-594-3438
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Fax | 800-518-6073
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Provider Business Mailing Address
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Address Line | 960 HOLCOMB BRIDGE RD SUITE 2-5
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City | ROSWELL
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State | GA
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Zip | 30076-1963
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Country | US
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Telephone | 770-594-3438
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. LAURA RESTREPO
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Credential |
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Telephone | 770-594-3438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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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 | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR1100X
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Taxonomy Name | Research Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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