Organization
CPMSC CANTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA BECK CFO (CHIEF FINANCIAL OFFICER)
(404) 920-4950
Entity
Organization
Contact information
Practice address
134 RIVERSTONE TERRACE, SUITE 102, CANTON, GA 30114
(770) 929-9033
(770) 929-9092
Mailing address
PO BOX 11407 DEPT 2570, BIRMINGHAM, AL 35246-2570
(770) 929-9033
(770) 929-9092
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/18/2013
Last updated
02/20/2020
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