# NWELITE SURGICAL LLC

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

## Provider details

- **NPI number:** 1982072609
- **Authorized official:** MRS. TELITA ANTHONY (CERTIFIED FIRST SURGICAL ASSIST)
- **Authorized official phone:** (770) 905-3089

## Contact information

- **Practice address:** 2205 THICKET CT NW, ACWORTH, GA 30102-7955
- **Practice address phone:** (770) 905-3089
- **Practice address fax:** (770) 675-3716
- **Mailing address:** PO BOX 492, KENNESAW, GA 30156-0492
- **Mailing address phone:** (770) 905-3089
- **Mailing address fax:** (770) 675-3716

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | Yes |
| 363AS0400X | Surgical Physician Assistant | — | — | Yes |

## Other

- **Enumeration date:** 09/11/2015
- **Last updated:** 02/26/2016