# INNOVATIVE MEDICAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novo Total Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003146143
- **Authorized official:** CONNIE Y JEON DPT, MPH (CLINIC DIRECTOR)
- **Authorized official phone:** (770) 988-2779

## Contact information

- **Practice address:** 1300 PEACHTREE INDUSTRIAL BLVD, SUITE 2203, SUWANEE, GA 30024-4539
- **Practice address phone:** (770) 988-2779
- **Practice address fax:** (678) 730-0229
- **Mailing address:** 1300 PEACHTREE INDUSTRIAL BLVD, SUITE 2203, SUWANEE, GA 30024-4539
- **Mailing address phone:** (770) 988-2779
- **Mailing address fax:** (678) 730-0229

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 058168 | GA | Yes |

## Other

- **Enumeration date:** 01/13/2010
- **Last updated:** 01/13/2010