Organization
CLINICA UNION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO RIVERA M.D (CEO)
(404) 321-4692
Entity
Organization
Contact information
Practice address
861 HOLCOMB BRIDGE RD, STE 200, ROSWELL, GA 30076-1900
(770) 992-4455
Mailing address
3369 BUFORD HWY NE, SUITE 810, BROOKHAVEN, GA 30329-3722
(404) 321-4692
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/20/2015
Last updated
08/20/2015
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