Organization
CONSULTORIO MEDICO HISPANO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTONIO MOLINA (BUSINESS MANAGER)
(678) 557-8292
Entity
Organization
Contact information
Practice address
3182 SHALLOWFORD RD NE, CHAMBLEE, GA 30341-3640
(678) 557-8292
Mailing address
3182 SHALLOWFORD RD NE, CHAMBLEE, GA 30341-3640
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
RN220493
GA
Other
Enumeration date
10/07/2016
Last updated
10/07/2016
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