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Organization

PREVENTIVE MEDICINE & CHELATION THERAPY INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERT A BURKICH MD (DIRECTOR)
(706) 891-1200
Entity
Organization

Contact information

Practice address
148 COBB PKWY, RINGGOLD, GA 30736-8566
(706) 891-1200
(706) 891-1202
Mailing address
148 COBB PKWY, RINGGOLD, GA 30736-8566
(706) 891-1200
(706) 891-1202

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
MD046372
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
511G70685
MEDICARE PTAN
Enumeration date
07/28/2008
Last updated
11/20/2013
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