Organization
EXECUTIVE MEDICAL PRACTICE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RASHELLE FOX (CREDITIALING)
(404) 664-2997
Entity
Organization
Contact information
Practice address
1455 BELLS FERRY RD STE 100, MARIETTA, GA 30066-6078
(770) 421-8094
(770) 421-8096
Mailing address
1455 BELLS FERRY RD STE 100, MARIETTA, GA 30066-6078
(770) 421-8094
(770) 421-8096
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/28/2023
Last updated
08/21/2023
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