Organization
PROFESSIONAL MEDICAL & REHAB CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL LEE (MEMBER)
(404) 748-4952
Entity
Organization
Contact information
Practice address
2636 MARTIN LUTHER KING JR DR SW, STE. 12, ATLANTA, GA 30311-1634
(404) 748-4952
(404) 696-2823
Mailing address
2636 MARTIN LUTHER KING JR DR SW, STE. 12, ATLANTA, GA 30311-1634
(404) 748-4952
(404) 696-2823
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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