Organization
EXPRESS MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD WT PHILIP (PRACTICE MANAGER)
(678) 263-6713
Entity
Organization
Contact information
Practice address
931 LOWER FAYETTEVILLE RD, SUITE J, NEWNAN, GA 30263-5790
(770) 715-9391
Mailing address
931 LOWER FAYETTEVILLE RD, SUITE J, NEWNAN, GA 30263-5790
(770) 715-9391
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
142462
GA
Other
Enumeration date
08/18/2011
Last updated
08/25/2011
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