Organization
BANNER HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOSTER JACOBS (OWNER)
(678) 993-3824
Entity
Organization
Contact information
Practice address
1256 OAKBROOK DR, STE C, NORCROSS, GA 30093-2247
(678) 993-3824
(678) 325-5601
Mailing address
1256 OAKBROOK DR, STE C, NORCROSS, GA 30093-2247
(678) 993-3824
(678) 325-5601
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
01/23/2016
Last updated
01/23/2016
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