Organization
A SYNERGISTIC APPROACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONI JANELL IDIAQUEZ LAC (OWNER)
(770) 313-0106
Entity
Organization
Contact information
Practice address
328 MAPLE ST, CARROLLTON, GA 30117-3235
(770) 313-0106
Mailing address
4685 CHAMBLEE DUNWOODY RD, J3, ATLANTA, GA 30338-6323
(770) 313-0106
(404) 474-7031
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
000063
GA
Other
Enumeration date
07/14/2008
Last updated
07/14/2008
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