Provider Demographics
NPI:1679300834
Name:ATLANTA ENERGY MEDICINE PRACTICE INCORPORATED
Entity type:Organization
Organization Name:ATLANTA ENERGY MEDICINE PRACTICE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENERGY MEDICINE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:ETHENIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:C-EM
Authorized Official - Phone:838-333-3989
Mailing Address - Street 1:1328 PEACHTREE ST NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3209
Mailing Address - Country:US
Mailing Address - Phone:838-333-3989
Mailing Address - Fax:
Practice Address - Street 1:260 PEACHTREE ST NW STE 2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-1292
Practice Address - Country:US
Practice Address - Phone:838-333-3989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty