Organization
WELLSTREET OF GEORGIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONIA RANA DAVIS (CREDENTIALING MANAGER)
(770) 809-3036
Entity
Organization
Contact information
Practice address
1755 HIGHWAY 34 E, SUITE 2150, NEWNAN, GA 30265-5631
(770) 202-2121
Mailing address
1755 HIGHWAY 34 E, SUITE 2150, NEWNAN, GA 30265-5631
(770) 202-2121
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
12/02/2019
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