Organization
TCWC LAWRENCEVILLE LLC
Active
Organization
TCWC LAWRENCEVILLE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER BLUE (CONTRACTING MANAGER)
(636) 978-0970
Entity
Organization
Contact information
Practice address
3157 SUGARLOAF PKWY STE 130, LAWRENCEVILLE, GA 30045-9492
(678) 828-4114
(404) 855-4184
Mailing address
3157 SUGARLOAF PKWY STE 130, LAWRENCEVILLE, GA 30045-9492
(678) 828-4114
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
CHIR009505
GA
Other
Enumeration date
08/04/2015
Last updated
06/16/2016
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