| Personal Wellness Inc. | |
|
625 Boxwood Ter Johns Creek GA 30005-7217 | |
| (770) 569-9429 | |
| Not Available |
| Full Name | Personal Wellness Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 625 Boxwood Ter, Johns Creek, Georgia |
| Authorized Official Name and Position | David Robert Rich (CEO) |
| Authorized Official Contact | 7705699429 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personal Wellness Inc. 625 Boxwood Ter Johns Creek GA 30005-7217 Ph: (770) 569-9429 | Personal Wellness Inc. 625 Boxwood Ter Johns Creek GA 30005-7217 Ph: (770) 569-9429 |
| NPI Number | 1780161323 |
|---|---|
| Provider Enumeration Date | 07/26/2018 |
| Last Update Date | 07/26/2018 |
| Medicare PECOS PAC ID | 7416292230 |
|---|---|
| Medicare Enrollment ID | O20181226001933 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780161323 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (NU) | Primary |
| Provider Name | Kenneth Rice |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831148063 PECOS PAC ID: 0547251126 Enrollment ID: I20080520000099 |
| Provider Name | Brandy Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003252412 PECOS PAC ID: 3779884432 Enrollment ID: I20151222001907 |
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