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Organization
PURE HEALTH MEDICINE LLC
Active
Organization
PURE HEALTH MEDICINE LLC
Active
Other names
Pure Health Medicine LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAULETTE DECONTEE KPANNAH (OWNER)
(678) 523-3663
Entity
Organization
Contact information
Practice address
905 SADDLE HL, MARIETTA, GA 30068-4915
(678) 842-8835
Mailing address
3966 JEFFERSON TOWNSHIP PKWY, MARIETTA, GA 30066-1704
(678) 523-3663
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/19/2021
Last updated
09/24/2021
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