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Organization

DOMINION ORTHOPAEDIC CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RUTH CLARK (PRACTICE ADMINISTRATOR)
(770) 455-4009
Entity
Organization

Contact information

Practice address
6 CONCOURSE PKWY STE 260, ATLANTA, GA 30328-6117
(770) 455-4009
(770) 455-4065
Mailing address
5555 PEACHTREE DUNWOODY RD NE, SUITE 215, ATLANTA, GA 30342-1703
(770) 455-4009
(770) 455-4065

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
037539
GA
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Enumeration date
03/02/2007
Last updated
01/04/2023
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