Organization
MLMCUC, LLC
Active
Other names
Mountain Lakes Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW LEMAK (CEO)
(205) 329-7501
Entity
Organization
Contact information
Practice address
180 LEGACY POINT, SUITE 201, CLAYTON, GA 30525
(706) 782-3100
Mailing address
162 LEGACY PT, CLAYTON, GA 30525-5354
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/24/2020
Last updated
08/18/2022
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