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 | 363AM0700X Physician Assistant, Medical (Licence: GA 002087) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 034091) |
208100000X Physical Medicine & Rehabilitation (Licence: GA 049316) | |
Enumeration Date | 2007-02-16 |
Last Update Date | 2025-09-11 |