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1114169703
EDG SPORTS MEDICINE,INC
DECATUR, GA
NPI
1114169703
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Entity Type
Organization
Authorized Contact
ERIC GAINES
Owner
404-296-5005
Organization Subpart ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: GA 1857)
Enumeration Date
2009-03-30
Last Update Date
2009-03-30
Business Address
EDG SPORTS MEDICINE,INC
2801 N DECATUR RD SUITE 200
DECATUR, GA 30033-5949
Phone number: 404-296-5005
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Mailing Address
EDG SPORTS MEDICINE,INC
1230 BRIARVISTA WAY
ATLANTA, GA 30329
Phone number: 404-296-5005
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