Provider Demographics
NPI:1023887684
Name:MENKE INVESTMENT, INC
Entity type:Organization
Organization Name:MENKE INVESTMENT, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-595-4700
Mailing Address - Street 1:306 CORRIGAN TRCE
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3287
Mailing Address - Country:US
Mailing Address - Phone:925-595-4700
Mailing Address - Fax:770-679-8752
Practice Address - Street 1:12195 HIGHWAY 92 STE 144
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30188-3603
Practice Address - Country:US
Practice Address - Phone:678-540-7827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MENKE INVESTMENT, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-25
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RB0002XAllopathic & Osteopathic PhysiciansInternal MedicineObesity MedicineGroup - Multi-Specialty