Organization
JORTAY DIAGNOSTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMIKA GOINS (MANAGING PARTNER)
(770) 364-2184
Entity
Organization
Contact information
Practice address
1290 KENNESTONE CIRCLE, BUILDING A, SUITE 112, MARIETTA, GA 30066-6009
(770) 364-2184
Mailing address
PO BOX 1157, WOODSTOCK, GA 30188-1157
(770) 364-2184
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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