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1831128578
IMMUNE RECOVERY FOUNDATION LLC
ATLANTA, GA
NPI
1831128578
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Entity Type
Organization
Authorized Contact
S. EDWARD BRADFORD
Owner
770-455-6100
Organization Subpart ?
No
Primary Taxonomy
302F00000X Exclusive Provider Organization
Enumeration Date
2006-07-03
Last Update Date
2020-08-22
Business Address
IMMUNE RECOVERY FOUNDATION LLC
4646 N SHALLOWFORD RD SUITE 200
ATLANTA, GA 30338-6304
Phone number: 770-455-6100
Copy
Mailing Address
IMMUNE RECOVERY FOUNDATION LLC
4646 N SHALLOWFORD RD SUITE 200
ATLANTA, GA 30338-6304
Phone number: 770-455-6100
Copy
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