Organization
FOREVER YOUNG LLC
Active
Parent organization
PAIN AND WELLNESS CENTERS OF GA
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAIN AND WELLNESS CENTERS OF GA
Authorized official
MR. ABRAHAM COHEN (OWNER)
(770) 680-5740
Entity
Organization
Contact information
Practice address
4905 LAVISTA RD STE E, TUCKER, GA 30084-4409
(678) 606-9833
Mailing address
4905 LAVISTA RD STE E, TUCKER, GA 30084-4409
(678) 606-9833
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00228865
GA
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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