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General NPI Number Information
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NPI Number | 1457602989
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Entity Type | Organization
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Legal Business Name | CROSSLINKS FAMILY PRACTICE & REHAB., LLC
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Dates
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Enumeration Date | 09/24/2012
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Last Update Date | 09/24/2012
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Provider Practice Location Address
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Address Line | 3300 CENTERVILLE HWY STE 1301
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City | SNELLVILLE
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State | GA
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Zip | 30039-5994
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Country | US
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Telephone | 404-597-2527
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 390005
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City | SNELLVILLE
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State | GA
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Zip | 30039-0001
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Country | US
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Telephone | 404-597-2527
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Fax |
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Authorized Official
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Title or Position | C.E.O/PRACTICE ADMINISTRATOR
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Name | MRS. ALICIA ASH
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Credential |
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Telephone | 404-597-2527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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