Organization
MACK XPRESS MEDICAL DIAGNOSTICS AND PHYSICALS
Active
Other names
Mack Xpress Medical Diagnostics and Physicals
Organization subpart
No
Provider details
NPI number
Authorized official
KAKETHIA S MACK NP (OWNER)
(678) 951-3794
Entity
Organization
Contact information
Practice address
45 PINE GROVE RD, LOCUST GROVE, GA 30248-2561
(470) 507-4444
(470) 878-4788
Mailing address
45 PINE GROVE RD, LOCUST GROVE, GA 30248-2561
(470) 507-4444
(470) 878-4788
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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