Organization
MILLENNIUM MEDICAL AND SPA CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIENE RUTHERFORD MD (MANAGER)
(954) 483-1436
Entity
Organization
Contact information
Practice address
12755 CENTURY DR UNIT A, ALPHARETTA, GA 30009-8377
(954) 483-1436
Mailing address
12755 CENTURY DR UNIT A, ALPHARETTA, GA 30009-8377
(954) 483-1436
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
09/20/2021
Last updated
09/20/2021
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