# GRUV WELLNESS CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700743069
- **Authorized official:** SAMANTHA BANKS NP (OWNER)
- **Authorized official phone:** (404) 857-4788

## Contact information

- **Practice address:** 1240 SIGMAN RD NW STE 103, CONYERS, GA 30012-3934
- **Practice address phone:** (404) 857-4788
- **Practice address fax:** (404) 596-6295
- **Mailing address:** 1240 SIGMAN RD NW STE 103, CONYERS, GA 30012-3934
- **Mailing address phone:** (404) 857-4788
- **Mailing address fax:** (404) 596-6295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2026
- **Last updated:** 05/27/2026