Organization
DUE WEST INTEGRATED HEALTH CENTER PHYSICAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN P LANIER M.D. (MEDICAL DIRECTOR)
(770) 429-5555
Entity
Organization
Contact information
Practice address
1600 KENNESAW DUE WEST RD NW, SUITE 501, KENNESAW, GA 30152-4301
(770) 429-5555
Mailing address
1600 KENNESAW DUE WEST RD NW STE 501, KENNESAW, GA 30152-4304
(770) 429-5555
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28809
GA
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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