Organization
PRE WELLNESS CARE ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJUA WATSON (COO)
(414) 238-4596
Entity
Organization
Contact information
Practice address
2001 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1101
(404) 691-3344
Mailing address
2001 MARTIN LUTHER KING JR DR SW, ATLANTA, GA 30310-1101
(404) 691-3344
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP0905X
State or Local Public Health Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
12/12/2019
Last updated
12/12/2019
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