| Living Well Onsite Wellness Clinic | |
|
701 Charles Gilman Jr Ave Suite B Kingsland GA 31548-5661 | |
| (912) 729-8942 | |
| (912) 729-1059 |
| Full Name | Living Well Onsite Wellness Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 Charles Gilman Jr Ave, Kingsland, Georgia |
| Authorized Official Name and Position | Cynthia R Popa (CLINIC DIRECTOR) |
| Authorized Official Contact | 9127298942 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Well Onsite Wellness Clinic 701 Charles Gilman Jr Ave Suite B Kingsland GA 31548-5661 Ph: (912) 729-8942 | Living Well Onsite Wellness Clinic 701 Charles Gilman Jr Ave Suite B Kingsland GA 31548-5661 Ph: (912) 729-8942 |
| NPI Number | 1831598135 |
|---|---|
| Provider Enumeration Date | 08/22/2014 |
| Last Update Date | 10/05/2023 |
| Medicare PECOS PAC ID | 2466420443 |
|---|---|
| Medicare Enrollment ID | O20240112003186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831598135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Melissa A White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053649657 PECOS PAC ID: 3971799404 Enrollment ID: I20101123000983 |
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