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Organization
PHYSICALS PLUS
Active
Organization
PHYSICALS PLUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRYSTAL NP-C BERRY NP-C (OWNER)
(404) 903-8019
Entity
Organization
Contact information
Practice address
3188 ATLANTA RD SE, SMYRNA, GA 30080-8256
(401) 903-8019
Mailing address
328 VININGS PKWY SE, SMYRNA, GA 30080-3906
(404) 903-8019
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NCO-000001
GA
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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