Organization
MLMCUC, LLC
Active
Other names
Mountain Lakes Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LEMAK (CEO)
(205) 536-7164
Entity
Organization
Contact information
Practice address
162 LEGACY PT STE C, CLAYTON, GA 30525-5354
(706) 960-9533
Mailing address
162 LEGACY PT, CLAYTON, GA 30525-5354
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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