EAGLE DRIVE FAMILY MEDICINE PC

WOODSTOCK, GA
NPI1750514295
Entity TypeOrganization
Authorized ContactRICHARD LEON MANRIQUE
President
678-445-5995
Organization Subpart ?No
Primary Taxonomy208D00000X General Practice
Enumeration Date2009-09-01
Last Update Date2012-01-25
Business Address
EAGLE DRIVE FAMILY MEDICINE PC
1816 EAGLE DR SUITE 200-B
WOODSTOCK, GA 30189-8272
Phone number: 678-445-5995
Mailing Address
EAGLE DRIVE FAMILY MEDICINE PC
1816 EAGLE DR SUITE 200-B
WOODSTOCK, GA 30189-8272
Phone number: 678-445-5995
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