Organization
PREVENTIVE MEDICINE & ANTI-AGING INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT A BURKICH MD (OWNER)
(770) 451-4857
Entity
Organization
Contact information
Practice address
171 MOUNT PARAN RD., SANDY SPRINGS, GA 30342-2211
(770) 451-4857
(678) 705-5767
Mailing address
171 MOUNT PARAN RD., SANDY SPRINGS, GA 30342-2211
(770) 451-4857
(678) 705-5767
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
MD046372
GA
Other
Enumeration date
05/09/2012
Last updated
05/17/2012
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