4Kloor LLC

Organization Active NPI Clinic/Center · Canton, GA

NPI 1780936252 · NPPES record last updated Oct 10, 2012

Key facts

NPI
1780936252
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
License
00658 (GA)
Legal business name
4KLOOR LLC
Practice address
1558 Marietta Hwy
230
Canton, GA 30114-3616
Phone
(678) 880-6879
Fax
(678) 880-8834
NPI assigned
Oct 9, 2012
Organization subpart
No

Authorized official

Name
Cesar Loor
Title
Physician Assistant
Phone
(678) 880-6879

National Provider Directory

Locations

1558 Marietta Hwy
Ste 230
Canton, GA 30114
Phone (678) 880-6879

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 160312 GA
Clinic/Center 261Q00000X
Clinic/Center 261Q00000X 00658 GA Yes

Addresses

Primary practice location

1558 Marietta Hwy
230
Canton, GA 30114-3616

Mailing address

1558 Marietta Hyw
230
Canton, GA 30114
Phone (678) 880-6879

Other providers in Canton, GA

All providers in Canton, GA · Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.