Organization
LA VISTA NORCROSS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUANA M SANCHEZ M.D (MEDICAL DIRECTOR)
(770) 446-2820
Entity
Organization
Contact information
Practice address
2625 BEAVER RUIN RD STE B, NORCROSS, GA 30071-4136
(770) 446-2820
(770) 446-2868
Mailing address
2625 BEAVER RUIN RD STE B, NORCROSS, GA 30071-4136
(770) 446-2820
(770) 446-2868
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
031536
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
043659295A
—
GA
Enumeration date
08/30/2011
Last updated
08/30/2011
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