Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Neurosciences
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR MEDICAL GROUP, LLC
Authorized official
MRS. NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(470) 644-0095
Entity
Organization
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2326
(770) 422-7797
Mailing address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2326
(770) 422-7797
Taxonomy
Speciality
Code
Description
License number
State
163WN0800X
Neuroscience Registered Nurse
—
GA
2084N0400X
Neurology Physician
Primary
—
GA
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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