Organization
ACTIVE CARE MEDICAL ASSOCIATES OF CONYERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN T. WILDER DC (CLINIC DIRECTOR)
(770) 761-2302
Entity
Organization
Contact information
Practice address
1229 SALEM GATE DRIVE, CONYERS, GA 30013
(770) 761-2302
(770) 761-2303
Mailing address
PMB#359 1040 HONEY CREEK ROAD, CONYERS, GA 30013
(770) 761-2302
(770) 761-2303
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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