Organization
AVVC MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMISH TILARA MD (PRESIDENT)
(678) 878-4555
Entity
Organization
Contact information
Practice address
600 PROFESSIONAL DR, LAWRENCEVILLE, GA 30046-7651
(678) 878-4555
Mailing address
600 PROFESSIONAL DR, LAWRENCEVILLE, GA 30046-7651
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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