Pristine Healthcare

NPI 1225477102 - Clinic/Center - 261QH0100X

NPI Details
NPI 1225477102
Enumeration Date 06/24/2013
Last Updated 06/24/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name MICHAEL ANTHONY MICHAEL
Position OWNER
Phone (404) 580-7642
Fax
Practice Location
5000 SERENITY POINT LN
VILLA RICA GA, 30180-6963, US
Phone (404) 580-7642
Fax
Business Location
5000 SERENITY POINT LN
VILLA RICA GA, 30180-6963, US
Phone (404) 580-7642
Fax
Toxanomy
Taxonomy Code 261QH0100X
License State Georgia
License Number 057975
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According to our database, Pristine Healthcare NPI is 1225477102, taxonomy code is 261QH0100X and license number is 057975, license state is located at Georgia. Pristine Healthcare physically located at 5000 Serenity Point Ln, Villa Rica GA, 30180-6963. NPI Number 1033115704 has the healthcare provider type.

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1225477102 NPI number is provided on an as is basis without warranty of any kind. 1225477102 is maintained by the National Plan & Provider Enumeration System. The contents of Pristine Healthcare are for informational purposes only.