# PATHWAY TO WELLNESS CENTER PC

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

## Provider details

- **NPI number:** 1902163991
- **Authorized official:** DR. IMO F NDEM M.D,M.P.H (MEDICAL DIRECTOR/PHYSICIAN)
- **Authorized official phone:** (706) 228-2929

## Contact information

- **Practice address:** 4111 OLD PETERSBURG RD, 4111 OLD PETERSBURG RD, MARTINEZ, GA 30907-3346
- **Practice address phone:** (706) 228-2929
- **Mailing address:** 4111 OLD PETERSBURG RD, 4111 OLD PETERSBURG RD, MARTINEZ, GA 30907-3346
- **Mailing address phone:** (706) 228-2929

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | 060968 | GA | Yes |
| 2083X0100X | Occupational Medicine Physician | 060968 | GA | — |

## Other

- **Enumeration date:** 04/16/2012
- **Last updated:** 04/16/2012