Organization
DOMINION ORTHOPAEDIC CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FOSTER III M.D. (PRESIDENT & CEO)
(770) 455-4009
Entity
Organization
Contact information
Practice address
5555 PEACHTREE DUNWOODY RD NE, # 215, ATLANTA, GA 30342-1703
(770) 455-4009
Mailing address
3607 OLD CONEJO RD, THOUSAND OAKS, CA 91320-2123
(805) 375-0800
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
AF3288328
GA
Other
Enumeration date
09/10/2007
Last updated
09/10/2007
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