Immune Recovery Foundation LLC

NPI #1831128578 in Atlanta, Georgia

Provider Information

NPI Number
1831128578
Entity Type
Organization
Organization Name
Immune Recovery Foundation LLC
Primary Specialty
Exclusive Provider Organization
Enumeration Date
Jul 3, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
4646 N SHALLOWFORD RD
Address 2
SUITE 200
State
Georgia
ZIP Code
30338-6304
Phone
(770) 455-6100

Authorized Official

Name
S. EDWARD BRADFORD, P.A.
Title
OWNER
Phone
(770) 455-6100

Specialties & Taxonomy Codes

Specialty
Exclusive Provider Organization

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