Organization
WELLSTREET OF GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER BROCK (CRED SUPERVISOR)
(678) 770-9005
Entity
Organization
Contact information
Practice address
789 CHURCH ST NE, MARIETTA, GA 30060-7237
(770) 881-7964
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/21/2021
Last updated
10/21/2021
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