| Organization Name: | REDICLINIC SERVICES |
| NPI Number: | 1013066950 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRIS KERSEY (DIRECTOR) |
| Mailing Address: | 1762 Mars Hill Rd Nw Acworth |
| State: | GA US |
| Postal Code: | 301018091 |
| Phone Number: | 8669350333 |
| Fax Number: | |
| NPI Enumeration Date: | 01/09/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | RN070078 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |