# SOUTH ATLANTA INTEGRATIVE MEDICINE

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

## Provider details

- **NPI number:** 1760848980
- **Authorized official:** LYNN STANLEY (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (404) 452-9931

## Contact information

- **Practice address:** 1240 HIGHWAY 54 W, BUILDING 700, SUITE 700, FAYETTEVILLE, GA 30214-4557
- **Practice address phone:** (404) 452-9931
- **Mailing address:** 1240 HIGHWAY 54 W, BUILDING 700, SUITE 700, FAYETTEVILLE, GA 30214-4557
- **Mailing address phone:** (404) 452-9931

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/04/2016
- **Last updated:** 01/04/2016