Organization
DEPARTMENT OF VETERANS AFFAIR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROSULA CRUZ-LAPORTE BSN,RN (STAFF NURSE)
(404) 321-6111
Entity
Organization
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
(404) 728-7746
Mailing address
3492 SKYLAND RIDGE CT, LOGANVILLE, GA 30052-8783
(404) 321-6111
(404) 728-7746
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
011861
PR
Other
Enumeration date
01/30/2008
Last updated
01/30/2008
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