Organization
KL MEDICAL CLINIC, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH OFOHA M.D. (PRESIDENT/OWNER)
(678) 773-7909
Entity
Organization
Contact information
Practice address
905 PARKSIDE WALK LN STE 100A, LAWRENCEVILLE, GA 30043-7314
(678) 442-9486
(678) 442-9488
Mailing address
PO BOX 492110, LAWRENCEVILLE, GA 30049-0036
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
68463
GA
Other
Enumeration date
09/28/2012
Last updated
03/24/2026
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