Organization
EAST ATLANTA ENDOSCOPY CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
7229 WHEAT ST NE, COVINGTON, GA 30014-1566
(678) 625-5132
(678) 625-5137
Mailing address
15305 DALLAS PKWY STE 1600, ADDISON, TX 75001-6491
(972) 763-3893
(972) 692-6745
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/24/2017
Last updated
07/24/2017
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