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 COORDINATOR)
(770) 809-3036
Entity
Organization
Contact information
Practice address
1155 CONCORD RD SE STE 200, SMYRNA, GA 30080-4207
(770) 809-3036
(404) 662-2399
Mailing address
3350 RIVERWOOD PKWY SE STE 1850, ATLANTA, GA 30339-3300
(770) 809-3036
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137211A
—
GA
Enumeration date
12/04/2018
Last updated
11/13/2019
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