# PREMISE HEALTH OF GEORGIA MEDICAL, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Wellness Center Operated by Premise Health Marietta North
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013790989
- **Authorized official:** WILL WRIGHT (LEGAL COUNSEL)
- **Authorized official phone:** (615) 577-5893

## Contact information

- **Practice address:** 86 SOUTH COBB DRIVE MAIL DROP 0454, MARIETTA, GA 30063-0001
- **Practice address phone:** (770) 494-4131
- **Practice address fax:** (770) 494-7490
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/15/2023
- **Last updated:** 08/15/2023