Organization
ADVANTAGE HEALTH & REHAB LLC
Active
Parent organization
COVENANT MEDICAL CENTER PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT MEDICAL CENTER PC
Authorized official
DR. PAUL WILLIS DC (CEO)
(770) 513-0111
Entity
Organization
Contact information
Practice address
1431 RIVERSIDE PARKWAY, LAWRENCEVILLE, GA 30043
(770) 513-0111
(770) 513-3731
Mailing address
1431 RIVERSIDE PARKWAY, LAWRENCEVILLE, GA 30043
(770) 513-0111
(770) 513-3731
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIR004786
GA
207R00000X
Internal Medicine Physician
Primary
58389
GA
363L00000X
Nurse Practitioner
RN051666
GA
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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