Organization
STR OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY MITCHELL (CEO)
(404) 769-1235
Entity
Organization
Contact information
Practice address
2566 SHALLOWFORD RD NE STE 104, ATLANTA, GA 30345-1200
(404) 769-1235
Mailing address
2566 SHALLOWFORD RD NE STE 104, ATLANTA, GA 30345-1200
(404) 769-1235
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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