NPI 1699834697

Medipractic LLC

Organisation Sports Medicine (Neuromusculoskeletal Medicine) Physician Loganville, GA

Practice location

Address: 3955 Harrison Rd STE. 400, Loganville, GA 30052-8501
Phone: (770) 496-0326
Fax: (770) 492-9599

Authorised official

Name: William E Willis
Title: Sec
Phone: (770) 496-0326

Registered specialties

Sports Medicine (Neuromusculoskeletal Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 204C00000X

Other Neuromusculoskeletal Medicine, Sports Medicine providers in Georgia →

Registry record

NPI: 1699834697
Entity type: Organization
NPI issued: 6 Dec 2006
Record last updated: 21 Dec 2012

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.