Greenline Medical Corporation

NPI 1073810453 - Pain Medicine - 208VP0000X

NPI Details
NPI 1073810453
Enumeration Date 02/19/2011
Last Updated 02/19/2011
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name KIMBERLY KIMBERLY
Position PHYSICIAN
Phone (770) 754-9880
Fax (770) 754-9881
Practice Location
804 BOMBAY LN
ROSWELL GA, 30076-5819, US
Phone (770) 754-9880
Fax (770) 754-9881
Business Location
804 BOMBAY LN
ROSWELL GA, 30076-5819, US
Phone
Fax
Toxanomy
Taxonomy Code 208VP0000X
License State Georgia
License Number 058478
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According to our database, Greenline Medical Corporation NPI is 1073810453, taxonomy code is 208VP0000X and license number is 058478, license state is located at Georgia. Greenline Medical Corporation physically located at 804 Bombay Ln, Roswell GA, 30076-5819. NPI Number 1033115704 has the healthcare provider type.

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1073810453 NPI number is provided on an as is basis without warranty of any kind. 1073810453 is maintained by the National Plan & Provider Enumeration System. The contents of Greenline Medical Corporation are for informational purposes only.