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Organization

QUALIFIED QUACKS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADRIENNE BOTOS CLARK BSN, RN (FOUNDER)
(770) 750-5099
Entity
Organization

Contact information

Practice address
1545 RAINIER FALLS DR NE, ATLANTA, GA 30329-4105
(404) 719-6746
Mailing address
1545 RAINIER FALLS DR NE, ATLANTA, GA 30329-4105
(404) 719-6746

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
207Q00000X
Family Medicine Physician
207R00000X
Internal Medicine Physician
261QM1300X
Multi-Specialty Clinic/Center
Primary
261QP2300X
Primary Care Clinic/Center
261QU0200X
Urgent Care Clinic/Center

Other

Enumeration date
10/18/2021
Last updated
10/18/2021
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