Back to Life Medical Group, LLC

NPI #1396987152 in Canton, Georgia

Provider Information

NPI Number: 1396987152
Entity Type: Organization
Organization Name: Back to Life Medical Group, LLC
Primary Specialty: Family Medicine
Enumeration Date: Mar 25, 2009
Last Updated: Nov 10, 2014

Practice Location

Address: 557 RIVERSTONE PKWY
Address 2: SUITE 140
City: Canton
State: Georgia
ZIP Code: 30114-5223
Phone: (770) 345-2000

Authorized Official

Name: DR. ERIC A CAVACIUTI
Title: OWNER
Phone: (770) 345-2000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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