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General NPI Number Information
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NPI Number | 1962146613
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Entity Type | Organization
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Legal Business Name | SUNRISE MOBILE PHLEBOTOMY
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Dates
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Enumeration Date | 04/27/2022
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 3929 VALLEY BROOK RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-4277
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Country | US
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Telephone | 404-447-3748
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Fax |
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Provider Business Mailing Address
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Address Line | 3929 VALLEY BROOK RD
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City | SNELLVILLE
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State | GA
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Zip | 30039-4277
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Country | US
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Telephone | 404-447-3748
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JACQUELINE HUNTER
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Credential |
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Telephone | 954-648-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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