Organization
OAKLEY FAMILY MEDICAL CLINIC LLX
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER B RUY M.D. (MEDICAL DIRECTOR)
(770) 969-0004
Entity
Organization
Contact information
Practice address
7794 ELLA LN, STE G, FAIRBURN, GA 30213-5511
(770) 969-0004
Mailing address
7794 ELLA LN, STE G, FAIRBURN, GA 30213-5511
(770) 969-0004
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
032649
GA
Other
Enumeration date
10/13/2010
Last updated
10/13/2010
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