PROVIDENCE RD PRIMARY CARE LLC

MARIETTA, GA
NPI1831537539
Entity TypeOrganization
Authorized ContactAMMA ABUNYEWA
Provider
770-973-4749
Organization Subpart ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: GA  64774)
Enumeration Date2013-06-05
Last Update Date2013-06-05
Business Address
PROVIDENCE RD PRIMARY CARE LLC
4180 PROVIDENCE RD STE 105
MARIETTA, GA 30062-6186
Phone number: 770-973-4749
Mailing Address
PROVIDENCE RD PRIMARY CARE LLC
4180 PROVIDENCE RD STE 105
MARIETTA, GA 30062-6186
Phone number: 770-973-4749
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