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General NPI Number Information
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NPI Number | 1942649215
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Entity Type | Organization
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Legal Business Name | PER DIEM HEALTHCARE, INC.
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Dates
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Enumeration Date | 06/20/2013
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Last Update Date | 06/20/2013
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Provider Practice Location Address
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Address Line | 2709 TREE MOUNTAIN PKWY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-6774
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Country | US
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Telephone | 678-278-9353
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Fax |
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Provider Business Mailing Address
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Address Line | 2709 TREE MOUNTAIN PKWY
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City | STONE MOUNTAIN
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State | GA
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Zip | 30083-6774
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Country | US
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Telephone | 678-278-9353
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS KENDRA MICHELLE TAYLOR
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Credential | LPN
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Telephone | 678-278-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State | GA
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