Provider Demographics
NPI:1073780391
Name:ADVANCED SLEEP SOLUTIONS OF ATLANTA
Entity Type:Organization
Organization Name:ADVANCED SLEEP SOLUTIONS OF ATLANTA
Other - Org Name:ASSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:WOOTEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA, RRT, RCP
Authorized Official - Phone:770-502-7009
Mailing Address - Street 1:209 COBBLESTONE CV
Mailing Address - Street 2:
Mailing Address - City:SHARPSBURG
Mailing Address - State:GA
Mailing Address - Zip Code:30277-1758
Mailing Address - Country:US
Mailing Address - Phone:770-502-7009
Mailing Address - Fax:770-252-0057
Practice Address - Street 1:209 COBBLESTONE CV
Practice Address - Street 2:
Practice Address - City:SHARPSBURG
Practice Address - State:GA
Practice Address - Zip Code:30277-1758
Practice Address - Country:US
Practice Address - Phone:770-502-7009
Practice Address - Fax:770-252-0057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic