# COLORECTAL WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1851035778
- **Authorized official:** ERIN KING-MULLINS MD (OWNER)
- **Authorized official phone:** (504) 473-3237

## Contact information

- **Practice address:** 1275 HIGHWAY 54 W STE 205, FAYETTEVILLE, GA 30214-4538
- **Practice address phone:** (770) 325-2275
- **Practice address fax:** (833) 707-2404
- **Mailing address:** 1275 HIGHWAY 54 W STE 205, FAYETTEVILLE, GA 30214-4538
- **Mailing address phone:** (770) 325-2275
- **Mailing address fax:** (833) 707-2404

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2022
- **Last updated:** 08/21/2024