Organization
PORT-A-WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMONA ANN MINNIS M..D. (MEDICAL DIRECTOR)
(678) 705-1691
Entity
Organization
Contact information
Practice address
1670 WASHINGTON AVE, EAST POINT, GA 30344-4248
(678) 705-1691
(855) 289-7475
Mailing address
1670 WASHINGTON AVE, EAST POINT, GA 30344-4248
(678) 705-1691
(855) 289-7475
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
042668
GA
Other
Enumeration date
03/11/2012
Last updated
03/11/2012
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