Provider Demographics
NPI:1508263849
Name:INTEGRATED HEALTH SOLUTIONS OF COBB COUNTY, INC
Entity Type:Organization
Organization Name:INTEGRATED HEALTH SOLUTIONS OF COBB COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-426-4315
Mailing Address - Street 1:3405 DALLAS HWY SW
Mailing Address - Street 2:SUITE 409
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-6425
Mailing Address - Country:US
Mailing Address - Phone:678-426-4315
Mailing Address - Fax:770-635-8641
Practice Address - Street 1:3405 DALLAS HWY SW
Practice Address - Street 2:SUITE 409
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-6425
Practice Address - Country:US
Practice Address - Phone:678-426-4315
Practice Address - Fax:770-635-8641
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty