Provider Demographics
NPI:1356719843
Name:COMPLETE HEALTHCARE MEDICAL CENTER
Entity type:Organization
Organization Name:COMPLETE HEALTHCARE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUZEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:770-813-0087
Mailing Address - Street 1:3460 SUMMIT RIDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-1622
Mailing Address - Country:US
Mailing Address - Phone:770-813-0087
Mailing Address - Fax:770-813-9006
Practice Address - Street 1:3460 SUMMIT RIDGE PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-1622
Practice Address - Country:US
Practice Address - Phone:770-813-0087
Practice Address - Fax:770-813-9006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-14
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty