Organization
EAGLE'S LANDING LONGEVITY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAYLA DENEICE SYLVAIN M.D (OWNER)
(770) 389-0734
Entity
Organization
Contact information
Practice address
1325 ROCK QUARRY RD, SUITE 200, STOCKBRIDGE, GA 30281-5088
(770) 389-0734
(770) 389-5364
Mailing address
1325 ROCK QUARRY RD, SUITE 200, STOCKBRIDGE, GA 30281-5088
(770) 389-0734
(770) 389-5364
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39958
GA
Other
Enumeration date
10/24/2014
Last updated
02/24/2020
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