| NPI | 1306980263 |
|---|---|
| Doing Business As | RIVERSIDE FAMILY MEDICAL |
| Entity Type | Organization |
| Authorized Contact | DAVE W. GEORGE Owner 678-407-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 034091) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: GA 049316) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 002087) | |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2020-08-22 |