Organization
RECHARGED WELLNESS CLUB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL JEROME WILLIAMS SR. AST (OWNER/ ADVANCED BODY RECOVERY PRACT)
(229) 234-9512
Entity
Organization
Contact information
Practice address
4510 VALNORTH DR, VALDOSTA, GA 31602-6875
(229) 234-9512
Mailing address
4510 VALNORTH DR, VALDOSTA, GA 31602-6875
(229) 234-9512
Taxonomy
Speciality
Code
Description
License number
State
261QR0800X
Recovery Care Clinic/Center
Primary
—
—
Other
Enumeration date
05/15/2026
Last updated
05/15/2026
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