Organization
CANTON MARKET PLACE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ODORISIO D.C, (OWNER)
(770) 674-6366
Entity
Organization
Contact information
Practice address
2050 CUMMING HWY, SUITE 100, CANTON, GA 30115-2314
(770) 674-6366
Mailing address
151 W MAIN ST, SUITE 204, CANTON, GA 30114-2757
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
GA
Other
Enumeration date
12/04/2015
Last updated
12/04/2015
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