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Organization

CLINICA SANTA MARIA 2, LLC

Active
Other names
Clinica Santa Maria 2, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ANTONIO MENDOZA (OFFICE MANAGER)
(770) 928-8450
Entity
Organization

Contact information

Practice address
6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
(770) 928-8450
(770) 928-8452
Mailing address
6158 HIGHWAY 92 STE 101, ACWORTH, GA 30102-2332
(770) 928-8450
(770) 928-8452

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207V00000X
Obstetrics & Gynecology Physician

Other

Enumeration date
07/12/2013
Last updated
07/12/2013
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