Organization
CLINIC KLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEAN M. LOMINY (MANAGER)
(770) 875-9988
Entity
Organization
Contact information
Practice address
1750 POWDER SPRINGS RD SW STE 510, MARIETTA, GA 30064-4849
(770) 875-8889
Mailing address
1750 POWDER SPRINGS RD SW STE 510, MARIETTA, GA 30064-4849
(770) 875-8889
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/14/2021
Last updated
11/16/2021
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