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Organization
WELLLCARE SURGICAL ASSISTING
Active
Organization
WELLLCARE SURGICAL ASSISTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DALTON (CEO)
(770) 490-8645
Entity
Organization
Contact information
Practice address
4455 LOWER ROSWELL RD, 684121, MARIETTA, GA 30068-0149
(770) 490-8645
Mailing address
4455 LOWER ROSWELL RD, 684121, MARIETTA, GA 30068-0149
(770) 490-8645
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
03/22/2017
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