Organization
PHYSICAL WELLNESS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARVEY B LESLIE M.D. (CEO)
(888) 683-2304
Entity
Organization
Contact information
Practice address
4153 FLAT SHOALS PKWY, BLDG A, DECATUR, GA 30034-4106
(888) 683-2304
Mailing address
11877 DOUGLAS RD STE 102299, JOHNS CREEK, GA 30005-4325
(888) 683-2304
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
027597
GA
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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