Organization
ICARE CLINIC & MEDSPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIKIRAT OROPO DNP (OWNER)
(770) 856-8988
Entity
Organization
Contact information
Practice address
4580 MEMORIAL DR, DECATUR, GA 30032-1447
(770) 856-8988
Mailing address
4580 MEMORIAL DR, DECATUR, GA 30032-1447
(404) 963-6861
(404) 963-6072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003246181A
003246181A
GA
05
—
734119526R
—
GA
01
—
G006535258
PTAN
GA
Enumeration date
02/02/2021
Last updated
02/07/2024
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