Organization
NORTHLAKE MULTISPECIALTY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK LOCKE (VP)
(615) 373-7604
Entity
Organization
Contact information
Practice address
1459 MONTREAL RD, SUITE 304, TUCKER, GA 30084-6900
(770) 908-4444
(770) 908-4400
Mailing address
1459 MONTREAL RD, SUITE 304, TUCKER, GA 30084-6900
(770) 908-4444
(770) 908-4400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/02/2006
Last updated
08/29/2007
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