Organization
TLC FOR WOMEN AFTER HOURS L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES R MOULTON II M.D. (CEO)
(770) 995-9100
Entity
Organization
Contact information
Practice address
2069 TERON TRCE, SUITE 100, DACULA, GA 30019-1665
(770) 995-9100
(770) 822-9444
Mailing address
2069 TERON TRCE, SUITE 100, DACULA, GA 30019-1665
(770) 995-9100
(770) 822-9444
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
043436
GA
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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