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Organization
WELLNESS FOR THE AGELESS WOMAN, INC
Active
Organization
WELLNESS FOR THE AGELESS WOMAN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA BATES (PRACTICE ADMINISTRATOR)
(770) 333-9405
Entity
Organization
Contact information
Practice address
4168 LOCH HIGHLAND PKWY NE, ROSWELL, GA 30075-2026
(770) 333-9405
(770) 333-9406
Mailing address
PO BOX 670927, MARIETTA, GA 30066-0133
(770) 333-9405
(770) 333-9406
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
033212
GA
Other
Enumeration date
07/29/2011
Last updated
07/29/2011
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