OrganizationActive
Post Acute Care Leaders LLC
NPI 1033689336 · Geriatric Medicine (Family Medicine) Physician · Carrollton, GA
Provider details
- NPI number
- 1033689336
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tyler Justiss, Controller(678) 593-3332
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Practice location
156 Pine Knoll Dr
Carrollton, GA 30117-2451
Phone: (678) 593-3332
Fax: (678) 868-1584
Approximate (ZIP-level) locationGet directions
Mailing address
925 N Point Pkwy Ste 425
Alpharetta, GA 30005-5200
Registry dates
- Enumerated
- 2018-11-29
- Last updated
- 2022-06-01
- Certified
- 2022-06-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.