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Organization

WELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC

Active
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Organization

WELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC

Active
Parent organization
WELLSTAR HEALTH SYSTEM, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
WELLSTAR HEALTH SYSTEM, INC.
Authorized official
NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization

Contact information

Practice address
1371 CHURCH STREET EXT NE, MARIETTA, GA 30060-7913
(770) 422-8315
(770) 590-9170
Mailing address
1371 CHURCH STREET EXT NE, MARIETTA, GA 30060-7913
(770) 422-8315
(770) 590-9170

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary

Other

Enumeration date
05/25/2006
Last updated
07/14/2008
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