Organization
RENECA CONTRACTING & CONSULTANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIS I EFOBI M.D (EXECUTIVE DIRECTOR)
(770) 879-7707
Entity
Organization
Contact information
Practice address
1525 E PARK PLACE BLVD, SUITE 300, STONE MOUNTAIN, GA 30087-3453
(770) 879-7707
(770) 879-7708
Mailing address
1525 E PARK PLACE BLVD, SUITE 300, STONE MOUNTAIN, GA 30087-3453
(770) 879-7707
(770) 879-7708
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
060727
GA
Other
Enumeration date
10/17/2015
Last updated
10/17/2015
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