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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