Organization
NEW IMAGE MEDICAL AESTHETIC AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREGORY P ZENGO MD (MEDICAL DIRECTOR)
(706) 769-5757
Entity
Organization
Contact information
Practice address
2 S MAIN ST, SUITE 206, WATKINSVILLE, GA 30677-7101
(706) 769-5757
Mailing address
2 S MAIN ST, SUITE 206, WATKINSVILLE, GA 30677-7101
(706) 769-5757
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
37738
GA
Other
Enumeration date
05/07/2015
Last updated
05/07/2015
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