Organization
OPULENT WELLNESS LLC
Active
Organization
OPULENT WELLNESS LLC
Active
Other names
Opulent Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KEISHA MONIQUE GWINN MT (OWNER)
(404) 955-1000
Entity
Organization
Contact information
Practice address
2221 PEACHTREE RD NE, STE. P33, ATLANTA, GA 30309-1148
(404) 955-1000
Mailing address
220 26TH ST NW, APT. 1117, ATLANTA, GA 30309-1914
(404) 955-1000
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
MT004320
GA
Other
Enumeration date
04/05/2010
Last updated
04/05/2010
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