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General NPI Number Information
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NPI Number | 1811422439
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Entity Type | Organization
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Legal Business Name | KWIK KARE OF GEORGIA, INC.
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Dates
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Enumeration Date | 04/21/2017
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Last Update Date | 04/21/2017
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Provider Practice Location Address
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Address Line | 2511 HIGHWAY 34 E SUITE C
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City | NEWNAN
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State | GA
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Zip | 30265-2309
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Country | US
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Telephone | 770-573-0167
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Fax | 678-809-2923
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Provider Business Mailing Address
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Address Line | 2511 HIGHWAY 34 E SUITE C
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City | NEWNAN
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State | GA
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Zip | 30265-2309
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Country | US
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Telephone | 770-573-0167
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Fax | 678-809-2923
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. LORI ELAINE KOZUSNIK
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Credential |
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Telephone | 770-573-0167
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | GA
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