Organization
OPTIWELL MD DULUTH LLC
Active
Other names
OptiWell MD
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY BELL FEDERICO (OWNER)
(404) 202-9433
Entity
Organization
Contact information
Practice address
4300 PLEASANT HILL RD, SUITE A, DULUTH, GA 30096-6379
(678) 682-8734
(678) 682-8736
Mailing address
8770 COLONIAL PL, DULUTH, GA 30097-6641
(404) 202-9433
(800) 845-0290
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
Primary
61722
GA
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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