Organization
EAST ATLANTA ENDOSCOPY CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (OFFICER / AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
1269 WELLBROOK CIR NE, CONYERS, GA 30012-3873
(770) 922-0505
(770) 922-1870
Mailing address
15305 DALLAS PKWY STE 1600, ADDISON, TX 75001-6491
(972) 763-3893
(972) 692-6745
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/02/2017
Last updated
03/17/2018
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