Organization
SYNERGISTIX UNIVERSAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXCIUS BRANCH (CEO)
(901) 606-7966
Entity
Organization
Contact information
Practice address
3522 HABERSHAM AT NORTHLAKE STE B, TUCKER, GA 30084-4009
(901) 606-7966
Mailing address
3522 HABERSHAM AT NORTHLAKE STE B, TUCKER, GA 30084-4009
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
—
—
261QC1500X
Community Health Clinic/Center
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
624120
COMMUNITY HEALTH/MULTI-SERVICE
GA
01
—
813319
COMMUNITY HEALTH/MULTI-SERVICE
GA
Enumeration date
03/19/2021
Last updated
03/19/2021
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