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1659688406
ATIVA HEALTH CENTER LLC
FORT WORTH, TX
NPI
1659688406
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Entity Type
Organization
Authorized Contact
YULIA POLIKHOVA
Owner
817-536-0219
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2010-08-31
Last Update Date
2010-08-31
Business Address
ATIVA HEALTH CENTER LLC
3510 E LANCASTER AVE SUITE B
FORT WORTH, TX 76103-2555
Phone number: 817-536-0219
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Mailing Address
ATIVA HEALTH CENTER LLC
3510 E LANCASTER AVE SUITE B
FORT WORTH, TX 76103-2555
Phone number: 817-536-0219
Copy
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