Organization
AAKP-MAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA LONG (OWNER/CEO)
(470) 273-1699
Entity
Organization
Contact information
Practice address
2000 RIVERSIDE PKWY STE 207, LAWRENCEVILLE, GA 30043-5926
(678) 646-0404
(678) 646-0202
Mailing address
2000 RIVERSIDE PKWY STE 207, LAWRENCEVILLE, GA 30043-5926
(678) 646-0404
(678) 646-0202
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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