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Organization

SPA1 CLINIC

Active
Other names
Buckeye Medical
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SARA BADIE (CEO)
(678) 368-2398
Entity
Organization

Contact information

Practice address
901 MARTIN RD, STONE MOUNTAIN, GA 30088-2110
(678) 368-2398
Mailing address
901 MARTIN RD, STONE MOUNTAIN, GA 30088-2110
(678) 368-2398

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
12/18/2008
Last updated
12/18/2008
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