Organization
WELL WOMAN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARKEITA MCINTOSH PA (OWNER)
(678) 463-0253
Entity
Organization
Contact information
Practice address
769 KNOX SPRINGS RD, AUSTELL, GA 30168-6313
(678) 463-0253
Mailing address
769 KNOX SPRINGS RD, AUSTELL, GA 30168-6313
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
03495
GA
Other
Enumeration date
01/23/2010
Last updated
01/23/2010
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