Organization
FIRST MOUNTAIN MEDICAL, LLC
Active
Organization
FIRST MOUNTAIN MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACI RENEE HARRIS (OWNER)
(770) 894-4939
Entity
Organization
Contact information
Practice address
640 WEST CHURCH ST, JASPER, GA 30143
(706) 253-3737
(706) 253-3747
Mailing address
640 WEST CHURCH ST, JASPER, GA 30143
(706) 253-3737
(706) 253-3747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
59919
GA
Other
Enumeration date
11/12/2010
Last updated
11/12/2010
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