Organization
ATLAS INITIATIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY PETERSON DC (OWNER/LEAD DOCTOR)
(770) 592-2505
Entity
Organization
Contact information
Practice address
2453 TOWNE LAKE PKWY STE A, WOODSTOCK, GA 30189-5525
(770) 592-2505
Mailing address
2307 STANTON PLACE LN, ACWORTH, GA 30101-8894
(402) 450-8664
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
11/16/2024
Last updated
11/16/2024
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