Provider Demographics
NPI:1962814624
Name:SAMS, BRIAN (LMT)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:SAMS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3535 PEACHTREE RD NE STE 520-310
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-3287
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2185 NORTHLAKE PKWY
Practice Address - Street 2:BLDG 8 STE100
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4126
Practice Address - Country:US
Practice Address - Phone:770-493-6360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist