Organization
DESTINY FAMILY MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OLAKUNLE AJIBOLA (CHIEF MEDICAL OFFICER)
(404) 721-2444
Entity
Organization
Contact information
Practice address
3654 CHATTAHOOCHEE SUMMIT DR SE, ATLANTA, GA 30339-3254
(404) 721-2444
Mailing address
3654 CHATTAHOOCHEE SUMMIT DR SE, ATLANTA, GA 30339-3254
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
064750
GA
Other
Enumeration date
11/16/2013
Last updated
11/16/2013
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