Organization
ACTIVATE YOUR HEALTH NUTRITION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY MECCIA (OWNER)
(678) 379-7882
Entity
Organization
Contact information
Practice address
1905 WOODSTOCK RD STE 7100, ROSWELL, GA 30075-5632
(678) 379-7882
Mailing address
241 CORNERSTONE DR, WOODSTOCK, GA 30188-5414
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LD003790
LICENSURE
GA
Enumeration date
12/26/2018
Last updated
05/19/2022
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