Provider Demographics
NPI:1336667997
Name:ABSOLUTE HOLISTIC MEDICINE
Entity Type:Organization
Organization Name:ABSOLUTE HOLISTIC MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JITAO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-393-9090
Mailing Address - Street 1:1868 INDEPENDENCE SQ, SUITE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:770-393-9090
Mailing Address - Fax:
Practice Address - Street 1:1868 INDEPENDENCE SQ, SUITE A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338
Practice Address - Country:US
Practice Address - Phone:770-393-9090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service