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Organization
CRH
Active
Organization
CRH
Active
Parent organization
1437194156
Other names
Patriot/Choice One
Organization subpart
Yes
Provider details
NPI number
Legal business name
1437194156
Authorized official
MICHELE LARKEE (BILLING LEAD)
(678) 573-9446
Entity
Organization
Contact information
Practice address
1275 HIGHWAY 54 W STE 201, FAYETTEVILLE, GA 30214-4538
(678) 688-9685
(770) 626-3791
Mailing address
1275 HIGHWAY 54 W STE 201, FAYETTEVILLE, GA 30214-4538
(678) 688-9685
(770) 626-3791
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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