Organization
PROMED ACCIDENT INJURY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY LEACH (BILLING)
(678) 736-6342
Entity
Organization
Contact information
Practice address
4646 N SHALLOWFORD RD, ATLANTA, GA 30338-6308
(770) 676-6000
(770) 392-9805
Mailing address
4646 N SHALLOWFORD RD, ATLANTA, GA 30338-6308
(770) 676-6000
(770) 392-9805
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/18/2015
Last updated
08/20/2015
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