Organization
PROHBO - MARIETTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER GRANT (OWNER)
(770) 421-8094
Entity
Organization
Contact information
Practice address
1455 BELLS FERRY RD, SUITE 100, MARIETTA, GA 30066-6078
(770) 421-8094
(770) 421-8096
Mailing address
1455 BELLS FERRY RD, SUITE 100, MARIETTA, GA 30066-6078
(770) 421-8094
(770) 421-8096
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/04/2006
Last updated
08/22/2020
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