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Organization

OPTIMUM HEALTH- HIRAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEX JUTIS (MGR.)
(770) 439-6997
Entity
Organization

Contact information

Practice address
76 HIGHLAND PAVILION CT, HIRAM, GA 30141-3169
(770) 439-6997
Mailing address
2855 HIGHWAY 317 STE 760-318, SUWANEE, GA 30024-3563

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
CHIRO06867
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary

Other

Enumeration date
09/16/2008
Last updated
09/16/2008
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