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Organization
VIDRO INDUSTRIES, LLC
Active
Organization
VIDRO INDUSTRIES, LLC
Active
Other names
Vidro Health Industries
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GLASS M,D. (PRESIDENT/CEO)
(404) 858-1063
Entity
Organization
Contact information
Practice address
20 HERRELL RD, VILLA RICA, GA 30180-5527
(770) 456-3929
Mailing address
PO BOX 1149, VILLA RICA, GA 30180-6149
(404) 858-1063
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62989
GA
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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