| Organization Name: | SUPERIOR HEALTHCARE OF CANTON, LLC |
| NPI Number: | 1619350329 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIA MCCLELLAN THORNE (OWNER) |
| Mailing Address: | 2050 Cumming Hwy Suite 100 Canton |
| State: | GA US |
| Postal Code: | 301152314 |
| Phone Number: | 7703459600 |
| Fax Number: | 7703459611 |
| NPI Enumeration Date: | 06/30/2015 |
| NPI Last Update Date: | 10/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14936 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |