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Organization
THERADOX
Active
Organization
THERADOX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BEVERLY IDRIS (NURSE)
(404) 464-8995
Entity
Organization
Contact information
Practice address
2705 CHURCH ST, SUITE B, EAST POINT, GA 30344-3209
(404) 464-8995
(404) 464-8998
Mailing address
2705 CHRUCH STREET, SUITE B, EAST POINT, GA 30344
(404) 464-8995
(404) 464-8998
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
07/22/2014
Last updated
07/22/2014
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