Organization
CLUB STAFFING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. B ENSHEBRA REYNOLDS RDMS (SONOGRAPHER)
(404) 444-9992
Entity
Organization
Contact information
Practice address
5901 BROKEN SOUND PKWY, SUITE 500, BOCA RATON, FL 33487-2773
(800) 875-8999
(561) 417-7443
Mailing address
307 ELIZABETH LN, GRIFFIN, GA 30223-4694
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
14796
GA
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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