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Back To Life Medical Group, Llc
Non-Pharmacy Dispensing Site in Canton, Georgia
NPI 1346526530

Back To Life Medical Group, Llc is a Non-Pharmacy Dispensing Site based in Canton, GA. Back To Life Medical Group, Llc practices in Canton, GA. The NPI Number for Back To Life Medical Group, Llc is 1346526530 and holds a License No. (Georgia).

The current practice location address for Back To Life Medical Group, Llc is 557 Riverstone Pkwy, Canton, GA and can be reached out via phone at 770-345-2000 and via fax at 770-345-4524. You can also correspond with Back To Life Medical Group, Llc through the mailing address at 557 RIVERSTONE PKWY, CANTON, GA - 30114-5223 (mailing address contact number: 770-345-2000).

Location: 557 Riverstone Pkwy, Canton, GA, 30114-5223
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1346526530
Provider Name
Back To Life Medical Group, Llc
Credential
Provider Entity Type
Organization
Address
557 Riverstone Pkwy, Canton, GA, 30114-5223
Phone Number
770-345-2000
Fax Number
770-345-4524
Provider Enumeration Date
11/01/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
557 Riverstone Pkwy
City
Canton
State
Georgia
Zip
30114-5223
Phone Number
770-345-2000
Fax Number
770-345-4524
person
Provider Business Mailing Address Details
Address
557 Riverstone Pkwy
City
Canton
State
Georgia
Zip
30114-5223
Phone Number
770-345-2000
Fax Number
770-345-4524
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
()
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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