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Organization

WOMENS HEALTHCARE AND AESTHETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELANIE MCMULLEN (PRACTICE MANAGER)
(770) 760-8484
Entity
Organization

Contact information

Practice address
5910 HILLANDALE DR STE 201, LITHONIA, GA 30058-1878
(770) 760-8484
(770) 760-7664
Mailing address
1403 MANCHESTER DR NE, CONYERS, GA 30012-3879
(770) 760-8484
(770) 760-7664

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
035507
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
393403
BC BS
GA
Enumeration date
03/13/2007
Last updated
08/22/2020
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