Organization
PIEDMONT PROFESSIONAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY AQUINO (DIRECTOR OF PROVIDER ENROLLMENT)
(470) 271-3427
Entity
Organization
Contact information
Practice address
1855 HUDSON BRIDGE RD, STOCKBRIDGE, GA 30281-5000
(770) 801-2500
(770) 803-2121
Mailing address
PO BOX 102038, ATLANTA, GA 30368-2038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RC0000X
Cardiovascular Disease Physician
—
GA
207RN0300X
Nephrology Physician
Primary
—
GA
Other
Enumeration date
07/02/2008
Last updated
08/10/2021
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