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Organization

METROMED,LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY GERARD RICHARDSON D.C. (PRINCIPAL PHYSICIAN)
(404) 606-0712
Entity
Organization

Contact information

Practice address
11348 TARA BLVE. STE.100, LOVEJOY, GA 30228-3558
(404) 606-0712
Mailing address
11348 TARA BLVD STE 100, HAMPTON, GA 30228-6277
(404) 933-5894

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
008459
GA
261QP2300X
Primary Care Clinic/Center
008459
GA
261QP3300X
Pain Clinic/Center
Primary
008459
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008459
GA
Enumeration date
06/26/2009
Last updated
07/21/2009
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