Organization
GEORGIA MUA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN SMITH MD (MEMBER)
(404) 788-6140
Entity
Organization
Contact information
Practice address
1276 MCCONNELL DR, STE. A&B, DECATUR, GA 30033-3508
(404) 348-4348
(877) 451-8595
Mailing address
1276 MCCONNELL DR, STE. A&B, DECATUR, GA 30033-3508
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
008268
GA
208VP0000X
Pain Medicine Physician
Primary
041961
GA
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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