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Organization
PRO-MEDICAL CENTER LLC
Active
Organization
PRO-MEDICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LEACH (BILLING)
(678) 736-6342
Entity
Organization
Contact information
Practice address
2090 DUNWOODY CLUB DR STE 106-241, ATLANTA, GA 30350-5434
(678) 736-6342
(678) 892-7428
Mailing address
4646 N SHALLOWFORD RD, ATLANTA, GA 30338-6308
(678) 736-6342
(678) 892-7428
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
GA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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