Organization
G. WELLS PETRAS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
G. WELLS PETRAS (OWNER)
(706) 424-6674
Entity
Organization
Contact information
Practice address
3675 LAWRENCEVILLE SUWANEE RD, SUWANEE, GA 30024-2328
(706) 424-6674
Mailing address
PO BOX 1541, COMMERCE, GA 30529-0030
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701003613
VA
101YM0800X
Mental Health Counselor
Primary
LPC004835
GA
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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