Organization
MIDTOWN WELLNESS GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FABIAN CENTENO (PRESIDENT OWNER)
(786) 246-2531
Entity
Organization
Contact information
Practice address
1874 PIEDMONT AVE NE, SUITE 390-C, ATLANTA, GA 30324-4869
(786) 246-2531
Mailing address
1874 PIEDMONT AVE NE, SUITE 390-C, ATLANTA, GA 30324-4869
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
08/22/2020
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