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Bold Legacy Practice, Llc
Clinic/Center in Marietta, Georgia
NPI 1962116392

Bold Legacy Practice, Llc is a Clinic/Center based in Acworth, GA. Bold Legacy Practice, Llc practices in Marietta, GA. The NPI Number for Bold Legacy Practice, Llc is 1962116392 and holds a License No. (Georgia).

The current practice location address for Bold Legacy Practice, Llc is 1401 Johnson Ferry Rd Ste 390, Marietta, GA and can be reached out via phone at 470-795-0047.

Location: 1401 Johnson Ferry Rd Ste 390, Marietta, GA, 30101-4696
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1962116392
Provider Name
Bold Legacy Practice, Llc
Credential
Provider Entity Type
Organization
Address
1401 Johnson Ferry Rd Ste 390, Marietta, GA, 30101-4696
Phone Number
470-795-0047
Fax Number
Provider Enumeration Date
01/10/2023
Last Update Date
03/13/2024
institution
Provider Business Practice Location Address Details
Address
1401 Johnson Ferry Rd Ste 390
City
Marietta
State
Georgia
Zip
30062-9100
Phone Number
470-795-0047
Fax Number
person
Provider Business Mailing Address Details
Address
1401 Johnson Ferry Rd Ste 390
City
Marietta
State
Georgia
Zip
30062-9100
Phone Number
470-795-0047
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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