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Organization

PREMIER AESTHETICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANGELA COPELAND CPC (PRACTICE MANAGER)
(678) 689-6485
Entity
Organization

Contact information

Practice address
5404 HILLANDALE PARK CT, LITHONIA, GA 30058-8803
(678) 418-6990
(678) 418-6986
Mailing address
5404 HILLANDALE PARK CT, LITHONIA, GA 30058-8803
(678) 418-6990
(678) 418-6986

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
08518
GA

Other

Enumeration date
10/04/2011
Last updated
04/22/2015
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