Ebt Holdings of Georgia Incorporated
NPI #1871287250 in Lawrenceville, Georgia
Provider Information
- NPI Number
- 1871287250
- Entity Type
- Organization
- Organization Name
- Ebt Holdings of Georgia Incorporated
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jun 7, 2023
- Last Updated
- Dec 5, 2023
Practice Location
- Address
- 1430 FIVE FORKS TRICKUM RD STE 220
- City
- Lawrenceville
- State
- Georgia
- ZIP Code
- 30044-8183
- Phone
- (786) 352-7021
Authorized Official
- Name
- ENRIQUE MASSUET VALDES
- Title
- VICE PRESIDENT
- Phone
- (786) 352-7021
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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