Organization
MID ATLANTIC MEDICAL MANAGEMENT , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATLEE THOMAS WAMPLER DC (CEO/OWNER)
(770) 504-5162
Entity
Organization
Contact information
Practice address
5904 OLD RICHMOND HIGHWAY, SUITE 515, ALEXANDRIA, VA 22303
(240) 754-7129
(240) 754-7128
Mailing address
PO BOX 566455, ATLANTA, GA 31156-6455
(770) 504-5162
(770) 392-9298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101254559
VA
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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