# HARLEY ANTI-AGING INSTITUTE LLC

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

## Provider details

- **NPI number:** 1447594569
- **Authorized official:** DR. SHARON A HARLEY (MEDICAL DOCTOR)
- **Authorized official phone:** (678) 500-1066

## Contact information

- **Practice address:** 2678 BUFORD HIGHWAY NE, ATLANTA, GA 30324
- **Practice address phone:** (678) 500-1066
- **Mailing address:** 2678 BUFORD HWY NE, ATLANTA, GA 30324-3240
- **Mailing address phone:** (678) 500-1066

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 170100000X | Ph.D. Medical Genetics | 28500 | GA | Yes |

## Other

- **Enumeration date:** 11/15/2012
- **Last updated:** 11/15/2012