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Organization
PEACHTREE ORTHOAPEDIC CLINIC, P.A.
Active
Organization
PEACHTREE ORTHOAPEDIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOLAN EDWARD MITCHELL CFO (CFO)
(404) 355-0743
Entity
Organization
Contact information
Practice address
2860 RONALD REAGAN BLVD STE 240, CUMMING, GA 30041-6289
(404) 355-0743
Mailing address
2860 RONALD REAGAN BLVD STE 240, CUMMING, GA 30041-6289
(404) 355-0743
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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