MID PROVIDER INC

ROSWELL, GA
NPI1962621532
Entity TypeOrganization
Authorized ContactPATRICIA J NORRIS
Director
404-229-0274
Organization Subpart ?No
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: GA  RN133089)
Enumeration Date2007-04-24
Last Update Date2010-01-05
Business Address
MID PROVIDER INC
1230 WORTHINGTON HILLS DR
ROSWELL, GA 30076-1753
Phone number: 404-229-0274
Mailing Address
MID PROVIDER INC
1230 WORTHINGTON HILLS DR
ROSWELL, GA 30076-1753
Phone number: 404-229-0274