Organization
ULTIMATE HYDRATION AND WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FOLAKE OSIBANJO NP-C (OWNER/MEMBER)
(203) 450-3051
Entity
Organization
Contact information
Practice address
1905 WOODSTOCK RD STE 6100, ROSWELL, GA 30075-5630
(470) 285-2750
(678) 404-5104
Mailing address
1905 WOODSTOCK RD STE 6100, ROSWELL, GA 30075-5630
(470) 285-2750
(678) 404-5104
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2021
Last updated
10/18/2021
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