Organization
PULMONARY WELLSTAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEDEL REYES MD (MD, SUPERVISING PHYSICIAN)
(770) 422-1372
Entity
Organization
Contact information
Practice address
55 WITCHER ST SUITE 160, MARIETTA, GA 30060
(770) 422-1372
Mailing address
335 SHADOWOOD PARKWAY APT 335, ATLANTA, GA 30339
(706) 333-9188
Taxonomy
Speciality
Code
Description
License number
State
284300000X
Special Hospital
Primary
—
—
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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