Organization
PCW ALLERGY LLC
Active
Other names
PCW Allergy & Asthma
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHANTEL G RUNNELS MBA (DIRECTOR OF OPERATIONS)
(470) 552-2277
Entity
Organization
Contact information
Practice address
1506 KLONDIKE RD SW STE 205, CONYERS, GA 30094-5173
(470) 377-6106
Mailing address
1506 KLONDIKE RD SW STE 205, CONYERS, GA 30094-5173
(470) 377-6106
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
207KA0200X
Allergy Physician
—
—
Other
Enumeration date
08/23/2021
Last updated
11/22/2021
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