Organization
ETOWAHCS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER M BRUTON (OWNER)
(678) 986-0453
Entity
Organization
Contact information
Practice address
200 LEAKE ST STE 106, CARTERSVILLE, GA 30120-3562
(770) 615-0218
Mailing address
200 LEAKE ST STE 106, CARTERSVILLE, GA 30120-3562
(770) 615-0218
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003229752A
—
GA
Enumeration date
02/04/2021
Last updated
09/06/2023
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