Organization
WELLSTREET OF GEORGIA PC
Active
Other names
Piedmont Urgentcare by Wellstreet
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA RANA DAVIS (CREDENTIALING CORRDINATOR)
(770) 809-3036
Entity
Organization
Contact information
Practice address
921 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5011
(770) 692-5910
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003177641A
—
GA
Enumeration date
04/25/2018
Last updated
11/19/2019
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