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Organization
SOUTHBRIDGE HOUSECALLS LLC
Active
Organization
SOUTHBRIDGE HOUSECALLS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALLYSON BLUE NP (NURSE PRACTITIONER/OWNER)
(404) 542-5017
Entity
Organization
Contact information
Practice address
7870 WATERLACE DR, FAIRBURN, GA 30213-4647
(404) 542-5017
Mailing address
7870 WATERLACE DR, FAIRBURN, GA 30213-4647
(404) 542-5017
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/09/2021
Last updated
04/09/2021
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