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Organization

DYNAMIC HEALTHCARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIDGET RANDOLPH NP (NURSE PRACTITIONER)
(405) 414-6002
Entity
Organization

Contact information

Practice address
130 EAGLE SPRING CT, SUITE A, STOCKBRIDGE, GA 30281-7274
(678) 616-2273
Mailing address
130 EAGLE SPRING CT, SUITE A, STOCKBRIDGE, GA 30281-7274
(678) 616-2273

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
230003
GA

Other

Enumeration date
08/13/2014
Last updated
08/13/2014
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