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Organization
YOUTHFUL ESSENCE MD, LLC
Active
Organization
YOUTHFUL ESSENCE MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FANNIE CLARK (REVENUE RECOVERY CONSULTANT)
(678) 531-9692
Entity
Organization
Contact information
Practice address
1230 JOHNSON FERRY PL, SUITE A10, MARIETTA, GA 30068-2048
(678) 903-0533
(678) 903-0548
Mailing address
1230 JOHNSON FERRY PL, SUITE A10, MARIETTA, GA 30068-2048
(678) 903-0533
(678) 903-0548
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17323874
GA
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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