Organization
BIG HART WELLNESS AND SPORTS ACADEMY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDGERTON HARTWELL (PRESIDENT)
(702) 301-4432
Entity
Organization
Contact information
Practice address
2021 W LIDDELL RD, SUITE B, DULUTH, GA 30096-8831
(702) 301-4432
Mailing address
5991 THOMPSON MILL RD, HOSCHTON, GA 30548-4029
(702) 301-4432
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
251T00000X
PACE Provider Organization
—
—
Other
Enumeration date
07/22/2015
Last updated
07/22/2015
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