Provider Demographics
NPI:1073153409
Name:AICA ORTHOPEDICS, P. C.
Entity Type:Organization
Organization Name:AICA ORTHOPEDICS, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:KERI
Authorized Official - Middle Name:
Authorized Official - Last Name:LANIADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-701-2225
Mailing Address - Street 1:PO BOX 674508
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30006-0076
Mailing Address - Country:US
Mailing Address - Phone:678-701-2225
Mailing Address - Fax:678-701-2226
Practice Address - Street 1:755 MOUNT VERNON HWY NE STE 305
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4290
Practice Address - Country:US
Practice Address - Phone:678-701-2225
Practice Address - Fax:678-701-2226
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AICA ORTHOPEDICS, P. C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty