Organization
UNIQUE CREATIONZ RX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARQUISHA GENERAL (OWNER)
(706) 587-2370
Entity
Organization
Contact information
Practice address
2500 DALLAS HWY SW STE 202-1082, MARIETTA, GA 30064-2567
(706) 587-2370
(770) 766-8337
Mailing address
2500 DALLAS HWY SW STE 202-1082, MARIETTA, GA 30064-2567
(706) 587-2370
(972) 645-4185
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
—
—
224P00000X
Prosthetist
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
06/02/2020
Last updated
06/16/2020
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