Organization
AIRPORT SPINAL INJURY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DETRICIA JOHNSON (MANAGER)
(404) 761-2855
Entity
Organization
Contact information
Practice address
809 NORTH CENTRAL AVE, HAPEVILLE, GA 30354
(404) 761-2855
Mailing address
809 NORTH CENTRAL AVE, HAPEVILLE, GA 30354
(404) 761-2855
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
2247
GA
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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