Organization
PRACTICAL WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA WITTKE MS RD LD (OWNER)
(770) 280-7732
Entity
Organization
Contact information
Practice address
889 STALLINGS AVE SE, ATLANTA, GA 30316-2209
(770) 280-7732
Mailing address
PO BOX 17710, ATLANTA, GA 30316-0710
(770) 280-7732
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1005X
Renal Nutrition Registered Dietitian
—
—
Other
Enumeration date
10/26/2011
Last updated
10/26/2011
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