Organization
ADVANCED MEDICAL WEIGHT LOSS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER JANE CLARK (OWNER)
(678) 294-0444
Entity
Organization
Contact information
Practice address
1100 SPRING ST NW, SUITE 150, ATLANTA, GA 30309-2846
(678) 294-0444
Mailing address
1490 LANE CREEK RD, BOGART, GA 30622-2627
(678) 294-0444
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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