# EASTERN HEALTH CENTER PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134383565
- **Authorized official:** DR. PATRICIA BENTON MD (CEO)
- **Authorized official phone:** (678) 701-2225

## Contact information

- **Practice address:** 1455 OLD MCDONOUGH HWY \#C, CONYERS, GA 30094
- **Practice address phone:** (678) 210-2225
- **Practice address fax:** (678) 201-2226
- **Mailing address:** PO BOX 500067, ATLANTA, GA 31150
- **Mailing address phone:** (678) 701-2225
- **Mailing address fax:** (678) 701-2226

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | Yes |
| 111N00000X | Chiropractor | — | — | Yes |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 07/15/2008
- **Last updated:** 07/15/2008