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1346850468
PROVISTA DIAGNOSTICS
ALPHARETTA, GA
NPI
1346850468
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Entity Type
Organization
Authorized Contact
URIEL KUSIATIN
CEO
470-758-2777
Organization Subpart ?
No
Primary Taxonomy
291U00000X Clinical Medical Laboratory
Enumeration Date
2020-08-04
Last Update Date
2020-08-04
Business Address
PROVISTA DIAGNOSTICS
2001 WESTSIDE PKWY STE 240
ALPHARETTA, GA 30004-7408
Phone number: 470-758-2777
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Mailing Address
PROVISTA DIAGNOSTICS
2001 WESTSIDE PKWY STE 240
ALPHARETTA, GA 30004-7408
Phone number: 470-758-2777
Copy
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