Organization
FIRSTSTOP MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLORY DIOH-ESONA FNP (OWNER)
(404) 494-6774
Entity
Organization
Contact information
Practice address
3375 MEMORIAL DR STE G, DECATUR, GA 30032-2706
(404) 494-6774
Mailing address
3375 MEMORIAL DR STE G, DECATUR, GA 30032-2706
(470) 446-2137
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/09/2024
Last updated
02/24/2025
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