Organization
LIFE CYCLE OB/GYN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANNE SIGOUIN (PRACTICE MANGER)
(404) 766-8371
Entity
Organization
Contact information
Practice address
107B UPPER RIVERDALE RD SW, RIVERDALE, GA 30274-2540
(404) 766-8371
Mailing address
2739 FELTON DR, EAST POINT, GA 30344-3603
(404) 766-8371
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
032592
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000415951E
—
GA
Enumeration date
05/05/2008
Last updated
05/05/2008
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