# CATALYST PHYSICAL MEDICINE LLC

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

## Provider details

- **NPI number:** 1396080925
- **Authorized official:** JENNIFER L DORGAN (PRESIDENT)
- **Authorized official phone:** (917) 881-9735

## Contact information

- **Practice address:** 4914 ATLANTA HWY, ALPHARETTA, GA 30004-2921
- **Practice address phone:** (770) 833-7907
- **Mailing address:** 4914 ATLANTA HWY, ALPHARETTA, GA 30004-2921
- **Mailing address phone:** (770) 833-7907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 64776 | GA | Yes |

## Other

- **Enumeration date:** 12/08/2012
- **Last updated:** 12/08/2012