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General NPI Number Information
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NPI Number | 1861821027
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Entity Type | Organization
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Legal Business Name | PEACHTREE ORTHOPAEDIC CLINIC, PC
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 1163 JOHNSON FERRY RD SUITE 200
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City | MARIETTA
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State | GA
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Zip | 30068-2764
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Country | US
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Telephone | 404-355-0743
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Fax | 404-355-2136
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Provider Business Mailing Address
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Address Line | 1163 JOHNSON FERRY RD SUITE 200
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City | MARIETTA
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State | GA
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Zip | 30068-2764
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Country | US
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Telephone | 404-355-0743
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Fax | 404-355-2136
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Authorized Official
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Title or Position | CFO
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Name | MS. MARIA SANDERS
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Credential |
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Telephone | 404-355-0743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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