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Organization

ENHANCED PHYSICAL MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MATTHEW EISEN DC (OWNER)
(770) 552-7500
Entity
Organization

Contact information

Practice address
622 W CROSSVILLE RD, 100, ROSWELL, GA 30075-2560
(770) 552-7500
(888) 819-9318
Mailing address
622 W CROSSVILLE RD, SUITE #100, ROSWELL, GA 30075-2560
(770) 552-7500
(888) 819-9318

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
CHIR007877
GA

Other

Enumeration date
06/23/2014
Last updated
06/23/2014
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