Organization
INTEGRATED MEDICAL OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRIQUE CRESPO (CLINIC ADMINISTRATOR)
(770) 428-4909
Entity
Organization
Contact information
Practice address
596 SEMINOLE DR NE, MARIETTA, GA 30060-1508
(770) 428-4909
Mailing address
596 SEMINOLE DR NE, MARIETTA, GA 30060-1508
(770) 428-4909
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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