Organization
LIFEHOPE TRIF3CTA SPORTS MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAESON COURSEAULT (OWNER)
(504) 982-7141
Entity
Organization
Contact information
Practice address
11680 GREAT OAKS WAY, ALPHARETTA, GA 30022-2457
(404) 500-7224
Mailing address
11680 GREAT OAKS WAY, ALPHARETTA, GA 30022-2457
(404) 500-7224
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
09/20/2021
Last updated
09/27/2021
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