Organization
IMC PRIMERA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAILESH KOTHARI DC (OWNER)
(888) 311-2976
Entity
Organization
Contact information
Practice address
800 VIRGINIA AVE, SUITE 200, HAPEVILLE, GA 30354-4302
(888) 311-2976
(404) 549-3393
Mailing address
800 VIRGINIA AVE, SUITE 200, HAPEVILLE, GA 30354-4302
(888) 311-2976
(404) 549-3393
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Enumeration date
04/05/2013
Last updated
04/05/2013
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