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Organization

CIRCLE SQUARED PROMOTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. ABDUL WANYE HAWKINS (PHYSICAL FITNESSTRAINER)
(678) 788-3646
Entity
Organization

Contact information

Practice address
555 WHITEHALL ST SW STE O, ATLANTA, GA 30303-3715
(678) 788-3646
Mailing address
PO BOX 1094, CONLEY, GA 30288-7000
(678) 788-3646

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
05/10/2019
Last updated
05/10/2019
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