Organization
INVICTUS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON CY GRINAGE MD (MEDICAL DIRECTOR)
(770) 580-0979
Entity
Organization
Contact information
Practice address
1545 POWERS FERRY RD SE STE 120, MARIETTA, GA 30067-9401
(770) 580-0979
(678) 383-6735
Mailing address
1545 POWERS FERRY RD SE STE 120, MARIETTA, GA 30067-9401
(770) 580-0979
(678) 383-6735
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
Other
Enumeration date
05/13/2020
Last updated
09/08/2024
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