Organization
BRAZEN WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER D JOHNSON (MEMBER)
(678) 234-3328
Entity
Organization
Contact information
Practice address
3144 ROCK PORT CIR, PEACHTREE CORNERS, GA 30092-2738
(678) 234-3328
Mailing address
3144 ROCK PORT CIR, PEACHTREE CORNERS, GA 30092-2738
(678) 234-3328
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
174H00000X
Health Educator
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
226300000X
Kinesiotherapist
—
—
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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