Organization
HIERARCHY FOR WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALVENA WINSTON (CONSULTANT)
(404) 406-6307
Entity
Organization
Contact information
Practice address
805 S GLYNN ST BLDG 127 142, FAYETTEVILLE, GA 30214
(404) 406-6307
Mailing address
805 S GLYNN ST BLDG 127 142, FAYETTEVILLE, GA 30214
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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