Organization
4KLOOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CESAR LOOR (PHYSICIAN ASSISTANT)
(678) 880-6879
Entity
Organization
Contact information
Practice address
1558 MARIETTA HWY, 230, CANTON, GA 30114-3616
(678) 880-6879
(678) 880-8834
Mailing address
1558 MARIETTA HYW, 230, CANTON, GA 30114
(678) 880-6879
(678) 880-8834
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
00658
GA
261Q00000X
Clinic/Center
160312
GA
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
10/09/2012
Last updated
10/10/2012
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