Organization
WELLSTAR KENNESTONE PEDIATRIC ASSOCIATES, LLC
Active
Parent organization
WELLSTAR HEALTH SYSTEM, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
WELLSTAR HEALTH SYSTEM, INC.
Authorized official
NICOLE ASHE (EXECUTIVE DIRECTOR OF FINANCE)
(770) 792-5261
Entity
Organization
Contact information
Practice address
1371 CHURCH STREET EXT NE, MARIETTA, GA 30060-7913
(770) 422-8315
(770) 590-9170
Mailing address
1371 CHURCH STREET EXT NE, MARIETTA, GA 30060-7913
(770) 422-8315
(770) 590-9170
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/25/2006
Last updated
07/14/2008
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