Organization
NORTHLAND MEDICAL LLC
Active
Other names
ATLANTA KETAMINE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ZACHARY DAVID LAZARUS MD (CO-OWNER)
(404) 709-2103
Entity
Organization
Contact information
Practice address
270 CARPENTER DR STE 515, ATLANTA, GA 30328-4949
(404) 803-0573
Mailing address
270 CARPENTER DR STE 515, ATLANTA, GA 30328-4949
(404) 803-0573
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/28/2024
Last updated
05/29/2024
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