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General NPI Number Information
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NPI Number | 1811005689
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Entity Type | Individual
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Provider Name | JULIUS LORINC SA
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 01/13/2011
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Provider Practice Location Address
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Address Line | 8310 ROYAL TROON DR
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City | DULUTH
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State | GA
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Zip | 30097-1681
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Country | US
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Telephone | 770-985-4257
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 ROYAL TROOL DR
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City | DULUTH
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State | GA
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Zip | 30097
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Country | US
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Telephone | 404-386-6814
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Fax | 678-417-0420
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1716
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License Number State | GA
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