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General NPI Number Information
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NPI Number | 1841337789
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Entity Type | Organization
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Legal Business Name | INTERNATIONAL ALTERNATIVE MEDICINE
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4450 HUGH HOWELL RD SUITE 5
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City | TUCKER
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State | GA
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Zip | 30084-4727
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Country | US
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Telephone | 770-934-4266
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 334
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City | TUCKER
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State | GA
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Zip | 30085-0334
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINSTRATOR
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Name | MS. CHAUNSAY BECKWITH
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Credential | RA
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Telephone | 770-934-4266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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