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General NPI Number Information
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NPI Number | 1770218505
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Entity Type | Organization
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Legal Business Name | THE MARLEY-MIRANDA GROUP, INC
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Dates
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Enumeration Date | 07/17/2022
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Last Update Date | 07/17/2022
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Provider Practice Location Address
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Address Line | 5673 PEACHTREE DUNWOODY RD
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City | SANDY SPRINGS
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State | GA
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Zip | 30342-1731
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Country | US
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Telephone | 833-885-4247
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Fax |
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Provider Business Mailing Address
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Address Line | 980 HOWELL MILL RD NW UNIT 1201
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City | ATLANTA
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State | GA
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Zip | 30318-5966
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Country | US
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Telephone | 833-885-4247
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. TAYLER ALYSE WALKER
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Credential | CRNA
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Telephone | 833-885-4247
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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