Organization
WELLNESS ALTERNATIVE MEDICINE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RASEAN HODGE M.D. (OWNER/PARTNER)
(770) 256-7033
Entity
Organization
Contact information
Practice address
619 BOULEVARD NE, SUITE A, ATLANTA, GA 30308-2701
(770) 256-7033
(678) 705-3717
Mailing address
619 BOULEVARD DRIVE, SUITE A, ATLANTA, GA 30308
(770) 256-7033
(678) 705-3717
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
054221
GA
261QI0500X
Infusion Therapy Clinic/Center
054221
GA
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
08/23/2016
Last updated
08/23/2016
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