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Organization

LEGACY HEALTH AND WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONNETTE FRANK RN (CHIEF COMPLIANCE OFFICER)
(770) 731-7700
Entity
Organization

Contact information

Practice address
1775 PARKER RD SE STE 210, CONYERS, GA 30094-6654
(707) 731-7700
Mailing address
1775 PARKER RD SE STE 210, CONYERS, GA 30094-6654
(707) 731-7700

Taxonomy

Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
163WG0000X
General Practice Registered Nurse
261QC1500X
Community Health Clinic/Center
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
05/05/2020
Last updated
05/05/2020
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