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Organization

LIFEHOPE MOBILE MEDICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SCOTT HONAN (SOLE MEMBER)
(404) 255-6358
Entity
Organization

Contact information

Practice address
11680 GREAT OAKS WAY STE 300, ALPHARETTA, GA 30022-2459
(404) 255-6358
Mailing address
3330 PRESTON RIDGE RD STE 380, ALPHARETTA, GA 30005-4596

Taxonomy

Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
207R00000X
Internal Medicine Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21064276
CONTROL NUMBER
GA
Enumeration date
08/27/2021
Last updated
08/27/2021
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