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Organization

AMARC MEDICAL & RESEARCH CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BONA ILONZO (ADMINISTRATOR)
(404) 838-0904
Entity
Organization

Contact information

Practice address
1309 LAKEWOOD AVE SE, ATLANTA, GA 30315-2312
(404) 838-0904
(770) 446-2686
Mailing address
PO BOX 767, FAIRBURN, GA 30213-0767
(404) 838-0904
(770) 446-2686

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Enumeration date
06/21/2007
Last updated
08/22/2020
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