Organization
THE FRATERNITY MEN'S HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SIMUEL BEASLEY III NP (OWNER/NURSE PRACTITIONER)
(404) 749-0571
Entity
Organization
Contact information
Practice address
540 POWDER SPRINGS ST STE B8, MARIETTA, GA 30064-3560
(404) 749-0571
(949) 864-3686
Mailing address
540 POWDER SPRINGS ST STE B8, MARIETTA, GA 30064-3560
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/18/2025
Last updated
08/14/2025
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