Lifetime Family Medicine Llc

NPI 1053509216 - Clinic/Center - 261QS1200X

NPI Details
NPI 1053509216
Enumeration Date 10/11/2007
Last Updated 12/19/2014
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name LISA H LISA
Position PRACTICE MANAGER
Phone (770) 459-8449
Fax
Practice Location
7869 VILLA RICA HWY
DALLAS GA, 30157-8638, US
Phone (770) 459-8449
Fax
Business Location
7869 VILLA RICA HWY
P.O. BOX 1926
DALLAS GA, 30157-8638, US
Phone (770) 459-8449
Fax
Toxanomy
Taxonomy Code 261QS1200X
License State Georgia
License Number 052082
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According to our database, Lifetime Family Medicine Llc NPI is 1053509216, taxonomy code is 261QS1200X and license number is 052082, license state is located at Georgia. Lifetime Family Medicine Llc physically located at 7869 Villa Rica Hwy, Dallas GA, 30157-8638. NPI Number 1033115704 has the healthcare provider type.

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1053509216 NPI number is provided on an as is basis without warranty of any kind. 1053509216 is maintained by the National Plan & Provider Enumeration System. The contents of Lifetime Family Medicine Llc are for informational purposes only.