Organization
HISPANIC MEDICAL MANAGEMENT
Active
Other names
CLINICA DE LA MAMA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE COTA (CFO)
(770) 613-0070
Entity
Organization
Contact information
Practice address
5127 JIMMY CARTER BLVD, NORCROSS, GA 30093-1619
(770) 613-0070
(770) 613-0990
Mailing address
4140 JONESBORO RD, FOREST PARK, GA 30297-1038
(404) 608-7123
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
GA
Other
Enumeration date
04/27/2007
Last updated
08/22/2020
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