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General NPI Number Information
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NPI Number | 1932423191
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Entity Type | Organization
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Legal Business Name | CHATTAHOOCHEE SLEEP CENTER LLC
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Dates
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Enumeration Date | 03/17/2010
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Last Update Date | 03/03/2012
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Provider Practice Location Address
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Address Line | 2410 DOUBLE CHURCHES RD STE B
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City | COLUMBUS
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State | GA
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Zip | 31909-2741
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Country | US
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Telephone | 706-221-7256
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Fax | 706-221-7254
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Provider Business Mailing Address
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Address Line | PO BOX 397
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City | MIDLAND
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State | GA
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Zip | 31820-0397
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Country | US
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Telephone | 706-221-7256
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Fax | 706-221-7254
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Authorized Official
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Title or Position | PARTNER
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Name | BRYANT HOUSTON
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Credential |
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Telephone | 706-563-1478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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