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Organization

PROVIDER PARTNERS, LLC DBA YOUR VIRTUAL CLINCIAL

Active
Parent organization
TKRR
Other names
Your Virtual Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
TKRR
Authorized official
RUTHERFORD POLHILL (OWNER)
(770) 401-5200
Entity
Organization

Contact information

Practice address
1815 SATELLITE BLVD STE 403, DULUTH, GA 30097-5239
(770) 401-5200
Mailing address
450 OLD PEACHTREE RD NW STE 101, SUWANEE, GA 30024-7289
(770) 401-5200

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary

Other

Enumeration date
11/12/2018
Last updated
03/16/2020
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