NPI 1588782346

Prohealth Integrated Medical

Organisation Legal Medicine Lawrenceville, GA

Practice location

Address: 1431 Riverside Pkwy, Lawrenceville, GA 30043-5946
Phone: (770) 513-0111
Fax: (770) 513-3731

Authorised official

Name: Christopher P Willis
Title: Owner
Phone: (770) 513-0111

Registered specialties (2)

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence 016356 (GA)

Other Legal Medicine providers in Georgia →

Chiropractor

Chiropractic Providers Taxonomy 111N00000X Licence CHIR005026 (GA)

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Registry record

NPI: 1588782346
Entity type: Organization
NPI issued: 27 Mar 2007
Record last updated: 8 Nov 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.