# MARIETTA NEUROLOGY AND HEADACHE CENTER, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marietta Neurological Assoc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073598488
- **Authorized official:** DR. THOMAS M HOLMES MD (MD MANAGING PARTNER)
- **Authorized official phone:** (770) 422-3602

## Contact information

- **Practice address:** 780 CANTON RD, STE 400, MARIETTA, GA 30060-7298
- **Practice address phone:** (770) 422-3602
- **Practice address fax:** (770) 421-6115
- **Mailing address:** 780 CANTON RD, STE 400, MARIETTA, GA 30060-7298
- **Mailing address phone:** (770) 422-3602
- **Mailing address fax:** (770) 421-6115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | NULL | Yes |
| 204D00000X | Neuromusculoskeletal Medicine & OMM Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2005
- **Last updated:** 06/07/2013