Organization
SWEETWATER COLLECTIVE LLC
Active
Parent organization
SWEETWATER COLLECTIVE LLC
Other names
Fayette Acupuncture & Integrative Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SWEETWATER COLLECTIVE LLC
Authorized official
BARBARA JOIE V JACALA LAC AEMP (CEO)
(678) 310-3182
Entity
Organization
Contact information
Practice address
101 DEVANT ST STE 1001, FAYETTEVILLE, GA 30214-2719
(678) 310-3182
(678) 788-6690
Mailing address
101 DEVANT ST STE 1001, FAYETTEVILLE, GA 30214-2719
(678) 310-3182
(678) 788-6690
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
521
ACUPUNCTURIST
GA
Enumeration date
06/02/2021
Last updated
02/08/2024
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