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General NPI Number Information
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NPI Number | 1831736339
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Entity Type | Organization
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Legal Business Name | AFFORDABLE CARE OF ONEONTA
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Dates
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Enumeration Date | 12/03/2019
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 908 2ND AVE E
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City | ONEONTA
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State | AL
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Zip | 35121-2506
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Country | US
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Telephone | 205-625-8389
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Fax |
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Provider Business Mailing Address
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Address Line | 908 2ND AVE E
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City | ONEONTA
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State | AL
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Zip | 35121-2506
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Country | US
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Telephone | 205-625-8389
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Fax | 205-273-8189
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Authorized Official
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Title or Position | OWNER
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Name | LESLIE DENISE DIODATO
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Credential | CRNP
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Telephone | 205-915-6057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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