Provider Demographics
NPI:1205590536
Name:THE PERFECT ARCH LLC
Entity type:Organization
Organization Name:THE PERFECT ARCH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-953-0001
Mailing Address - Street 1:501 ROBERTS CT NW STE 10
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4968
Mailing Address - Country:US
Mailing Address - Phone:678-398-9539
Mailing Address - Fax:
Practice Address - Street 1:501 ROBERTS CT NW STE 10
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4968
Practice Address - Country:US
Practice Address - Phone:678-398-9539
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center