Organization
CIAO BELLA MEDICAL CENTER AND SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LATOYA BENITA STEPHENS M.D. (OWNER/PHYSICIAN)
(770) 683-9136
Entity
Organization
Contact information
Practice address
175 JEFFERSON PKWY, NEWNAN, GA 30263-5823
(770) 683-9136
(770) 683-9148
Mailing address
6400 INDUSTRIAL LOOP, GREENDALE, WI 53129-2452
(414) 423-4100
(414) 423-4134
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
58512
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400993872F
—
GA
Enumeration date
03/19/2013
Last updated
03/10/2022
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