Organization
VIDA-FLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN KANE M.D. (SUPERVISING PHYSICIAN)
(573) 825-6097
Entity
Organization
Contact information
Practice address
2221 PEACHTREE RD NE STE Q, ATLANTA, GA 30309-1106
(404) 343-4973
Mailing address
2221 PEACHTREE RD NE STE Q, ATLANTA, GA 30309-1106
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
7919
GA
Other
Enumeration date
04/28/2017
Last updated
04/28/2017
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