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Organization
CHILDRENS CLINIC LLC
Active
Organization
CHILDRENS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTI FERGUSON (MANAGER)
(770) 253-0170
Entity
Organization
Contact information
Practice address
931 LOWER FAYETTEVILLE RD STE J, NEWNAN, GA 30263-5790
(770) 253-0170
(770) 253-0206
Mailing address
931 LOWER FAYETTEVILLE RD STE J, NEWNAN, GA 30263-5790
(770) 253-0170
(770) 253-0206
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
08/29/2017
Last updated
07/21/2022
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