Wellstreet of Georgia PC

NPI #1487126637 in Smyrna, Georgia

Provider Information

NPI Number
1487126637
Entity Type
Organization
Organization Name
Wellstreet of Georgia PC
Primary Specialty
Non-Pharmacy Dispensing Site
Enumeration Date
Dec 28, 2018
Last Updated
Dec 28, 2018

Practice Location

Address
1155 CONCORD RD SE STE 200
City
Smyrna
State
Georgia
ZIP Code
30080-4207
Phone
(678) 600-5137

Authorized Official

Name
KEESHA D. PINACLE
Title
CREDENTIALING MANAGER
Phone
(770) 809-3036

Specialties & Taxonomy Codes

Specialty
Non-Pharmacy Dispensing Site

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