Organization
RESTORE FIRST HEALTH RIVERDALE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL LEE HAUPT MHA (EXECUTIVE VICE PRESIDENT, SGI)
(931) 494-7057
Entity
Organization
Contact information
Practice address
34 UPPER RIVERDALE RD SE STE 101, RIVERDALE, GA 30274-2635
(470) 292-3820
(470) 280-9511
Mailing address
10680 MEDLOCK BRIDGE RD STE 101, JOHNS CREEK, GA 30097-8420
(470) 292-3820
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
10/29/2024
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