Organization
IMPACT WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TEFYLON CAMERON DC (ADMINISTRATIVE MANAGER)
(678) 717-9299
Entity
Organization
Contact information
Practice address
1989 N WILLIAMSBURG DR, SUITE E, DECATUR, GA 30033-5998
(678) 717-9299
(404) 492-8885
Mailing address
1989 N WILLIAMSBURG DR, SUITE E, DECATUR, GA 30033-5998
(678) 717-9299
(404) 492-8885
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
GA050322
GA
Other
Enumeration date
03/29/2017
Last updated
03/29/2017
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