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Organization
ACTIVE CARE MEDICAL ASSOCIATES OF CONYERS, LLC
Active
Organization
ACTIVE CARE MEDICAL ASSOCIATES OF CONYERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN T. WILDER DC (CLINIC DIRECTOR)
(770) 761-2302
Entity
Organization
Contact information
Practice address
1229 SALEM GATE DRIVE, CONYERS, GA 30013
(770) 761-2302
(770) 761-2303
Mailing address
PMB#359 1040 HONEY CREEK ROAD, CONYERS, GA 30013
(770) 761-2302
(770) 761-2303
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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