Organization
THE BREAST CARE TEAM , PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANITA T JOHNSON (PHYSICIAN/OWNER)
(770) 704-6977
Entity
Organization
Contact information
Practice address
130 RIVERSTONE TER, SUITE 101, CANTON, GA 30114-1702
(770) 704-6977
(770) 704-6169
Mailing address
130 RIVERSTONE TER, SUITE 101, CANTON, GA 30114-1702
(770) 704-6977
(770) 704-6169
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
053464
GA
Other
Enumeration date
10/15/2007
Last updated
12/19/2007
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