# MEDPRIME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Wellness Plus Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265711634
- **Authorized official:** MARK REZNIK (PRACTICE ADMINISTRATOR)
- **Authorized official phone:** (770) 392-7160

## Contact information

- **Practice address:** 3 RAVINIA DR, SUITE P-160, ATLANTA, GA 30346-2118
- **Practice address phone:** (770) 392-7160
- **Practice address fax:** (770) 392-7163
- **Mailing address:** PO BOX 501741, ATLANTA, GA 31150-1741
- **Mailing address phone:** (770) 392-7160
- **Mailing address fax:** (770) 392-7163

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | CHIRO07312 | GA | — |
| 208D00000X | General Practice Physician | 044023 | GA | Yes |

## Other

- **Enumeration date:** 08/16/2011
- **Last updated:** 08/16/2011