Organization Name: | ADVANCED INTEGRATED HEALTH & PHYSICAL MEDICINE |
NPI Number: | 1962802512 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYNNE CUNNINGHAM (PHYSICIAN) |
Mailing Address: | 325 Hammond Dr Suite 201-a Atlanta |
State: | GA US |
Postal Code: | 303285032 |
Phone Number: | 4042560114 |
Fax Number: | 4042560167 |
NPI Enumeration Date: | 09/02/2014 |
NPI Last Update Date: | 09/02/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 049970 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |