Organization
WELLSTAR MEDICAL GROUP, LLC
Active
Parent organization
WELLSTAR MEDICAL GROUP, LLC
Other names
WellStar Rehabilitation
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
100 LACY ST NW, SUITE 150, MARIETTA, GA 30060-1271
(770) 793-7635
(770) 793-7645
Mailing address
100 LACY ST NW, SUITE 150, MARIETTA, GA 30060-1271
(770) 793-7635
(770) 793-7645
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
GA
Other
Enumeration date
05/24/2011
Last updated
11/19/2013
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