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General NPI Number Information
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NPI Number | 1477364461
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Entity Type | Organization
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Legal Business Name | ATLANTA BODY CARE, LLC
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Dates
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Enumeration Date | 01/17/2025
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Last Update Date | 01/17/2025
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Provider Practice Location Address
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Address Line | 500 SUN VALLEY DR STE D1
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City | ROSWELL
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State | GA
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Zip | 30076-5636
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Country | US
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Telephone | 770-355-8352
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Fax |
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Provider Business Mailing Address
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Address Line | 803 SWEET APPLE CIR
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City | ALPHARETTA
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State | GA
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Zip | 30004-6658
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Country | US
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Telephone | 770-355-8352
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Fax |
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Authorized Official
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Title or Position | ORGANIZER
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Name | DR. ROSALIND GAMBA
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Credential | NMD
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Telephone | 770-355-8352
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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