Organization
CMP IMPACT THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CORANNE POLK CPC (CEO)
(478) 225-6404
Entity
Organization
Contact information
Practice address
1906 ELBERTA RD STE C, WARNER ROBINS, GA 31093-1391
(478) 225-6404
Mailing address
1906 ELBERTA RD STE C, WARNER ROBINS, GA 31093-1391
(478) 225-6404
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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