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Organization

SUPPORTING YOUR DAILY HEALTH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YVONNE WICKS PA (MANAGER)
(404) 790-0911
Entity
Organization

Contact information

Practice address
147 NORTH AVE NE, ATLANTA, GA 30308-2328
(404) 438-7569
Mailing address
3695 CASCADE RD SW STE F, STE 1158, ATLANTA, GA 30331-2146
(404) 438-7569

Taxonomy

Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
005833
GA
207RN0300X
Nephrology Physician
Primary
65587
GA
363AM0700X
Medical Physician Assistant
004315
GA

Other

Enumeration date
08/08/2011
Last updated
02/25/2025
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