QRC 360 ENTERPRISES
Organization (NPI-2)
Active
Family Medicine
Provider Information
- NPI Number
1912407719- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 12195 HIGHWAY 92 STE 144, WOODSTOCK, GA, 301883603
- Phone
- (678) 540-7827
Specialties & Taxonomies
Nurse Practitioner, Family
License: GA #218918RN
Family Medicine
Primary License: GA #30053