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Organization

CIVICORE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
INDIA L HARRISON (OWNER / AUTHORIZED REPRESENTATIVE)
(770) 762-2663
Entity
Organization

Contact information

Practice address
3950 COBB PKWY NW STE 101, ACWORTH, GA 30101-9522
(770) 752-2663
(770) 415-8277
Mailing address
3950 COBB PKWY NW STE 101, ACWORTH, GA 30101-9522
(770) 762-2663
(770) 415-8277

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Enumeration date
01/19/2026
Last updated
01/19/2026
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