Organization
WGUAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARC MORIN MBA (PRACTICE ADMINISTRATOR)
(678) 390-7164
Entity
Organization
Contact information
Practice address
150 CLINIC AVE, SUITE 202, CARROLLTON, GA 30117-4401
(770) 834-6988
(770) 834-1090
Mailing address
150 CLINIC AVE, SUITE 202, CARROLLTON, GA 30117-4401
(770) 834-6988
(770) 834-1090
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
GA
Other
Enumeration date
04/08/2015
Last updated
04/08/2015
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