| 4kloor LLC | |
|
1558 Marietta Hwy 230 Canton GA 30114-3616 | |
| (678) 880-6879 | |
| (678) 880-8834 |
| Full Name | 4kloor LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 1558 Marietta Hwy, Canton, Georgia |
| Authorized Official Name and Position | Cesar Loor (PHYSICIAN ASSISTANT) |
| Authorized Official Contact | 6788806879 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 4kloor LLC 1558 Marietta Hyw 230 Canton GA 30114 Ph: (678) 880-6879 | 4kloor LLC 1558 Marietta Hwy 230 Canton GA 30114-3616 Ph: (678) 880-6879 |
| NPI Number | 1780936252 |
|---|---|
| Provider Enumeration Date | 10/09/2012 |
| Last Update Date | 10/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780936252 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 160312 (Georgia) | Secondary |
| 261Q00000X | Clinic/center | () | Secondary |
| 261Q00000X | Clinic/center | 00658 (Georgia) | Primary |
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