Organization
LONGER LIFE SERVICES OF GA CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PABLO SANU (PRESIDENT)
(404) 438-1293
Entity
Organization
Contact information
Practice address
1025 ROSE CREEK DR, SUITE 620-173, WOODSTOCK, GA 30189-6797
(404) 438-1293
Mailing address
1025 ROSE CREEK DR, SUITE 620-173, WOODSTOCK, GA 30189-6797
(404) 438-1293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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