| Port-a-wellness Llc | |
|
1670 Washington Ave East Point GA 30344-4248 | |
| (678) 705-1691 | |
| (855) 289-7475 |
| Full Name | Port-a-wellness Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1670 Washington Ave, East Point, Georgia |
| Authorized Official Name and Position | Ramona Ann Minnis (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6787051691 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Port-a-wellness Llc 1670 Washington Ave East Point GA 30344-4248 Ph: (678) 705-1691 | Port-a-wellness Llc 1670 Washington Ave East Point GA 30344-4248 Ph: (678) 705-1691 |
| NPI Number | 1063787901 |
|---|---|
| Provider Enumeration Date | 03/11/2012 |
| Last Update Date | 03/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063787901 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 042668 (Georgia) | Primary |
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