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Organization
CANTON FAMILY CARE
Active
Organization
CANTON FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORISE A HOUSE (INSURANCE MANAGER)
(770) 479-1494
Entity
Organization
Contact information
Practice address
200 MEDICAL LN, CANTON, GA 30114-2421
(770) 479-1494
(770) 720-3492
Mailing address
200 MEDICAL LN, CANTON, GA 30114-2421
(770) 479-1494
(770) 720-3492
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
015374
GA
Other
Enumeration date
01/23/2007
Last updated
12/29/2009
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