| G. Wells Petras, Llc | |
|
3675 Lawrenceville Suwanee Rd Suwanee GA 30024-2328 | |
| (706) 424-6674 | |
| Not Available |
| Full Name | G. Wells Petras, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3675 Lawrenceville Suwanee Rd, Suwanee, Georgia |
| Authorized Official Name and Position | G. Wells Petras (OWNER) |
| Authorized Official Contact | 7064246674 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| G. Wells Petras, Llc Po Box 1541 Commerce GA 30529-0030 Ph: () - | G. Wells Petras, Llc 3675 Lawrenceville Suwanee Rd Suwanee GA 30024-2328 Ph: (706) 424-6674 |
| NPI Number | 1629210430 |
|---|---|
| Provider Enumeration Date | 03/26/2009 |
| Last Update Date | 03/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629210430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 0701003613 (Virginia) | Secondary |
| 101YM0800X | Counselor - Mental Health | LPC004835 (Georgia) | Primary |
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