Organization
RENEW WELLNESS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY PETIT (OWNER)
(678) 615-4029
Entity
Organization
Contact information
Practice address
11348 TARA BLVD, STE 100, HAMPTON, GA 30228-6277
(678) 466-6424
(678) 466-6464
Mailing address
11348 TARA BLVD, STE 100, HAMPTON, GA 30228-6277
(678) 466-6424
(678) 466-6464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
048349
GA
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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