Organization
LIFE HEALTH & WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE MCCALL-GASTON APRN-BC (CEO)
(678) 641-4391
Entity
Organization
Contact information
Practice address
1707 NORTH BLAIRS BRIDGE RD, AUSTELL, GA 30168
(470) 513-3908
(770) 502-6492
Mailing address
1707 NORTH BLAIRS BRIDGE RD, AUSTELL, GA 30168
(470) 513-3908
(770) 502-6492
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137957D
—
GA
Enumeration date
07/01/2021
Last updated
10/28/2021
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