| Welltouch Wellness Clinic LLC | |
|
252 Shannon Way Lawrenceville GA 30044-3793 | |
| (404) 409-9439 | |
| Not Available |
| Full Name | Welltouch Wellness Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 252 Shannon Way, Lawrenceville, Georgia |
| Authorized Official Name and Position | Jennifer Charlene Pean-winston (CEO/PROVIDER/OWNER) |
| Authorized Official Contact | 4044099439 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Welltouch Wellness Clinic LLC 3685 Warwick Way Snellville GA 30039-8069 Ph: (404) 409-9439 | Welltouch Wellness Clinic LLC 252 Shannon Way Lawrenceville GA 30044-3793 Ph: (404) 409-9439 |
| NPI Number | 1780466532 |
|---|---|
| Provider Enumeration Date | 10/17/2023 |
| Last Update Date | 10/17/2023 |
| Certification Date | 10/17/2023 |
| Medicare PECOS PAC ID | 3870943038 |
|---|---|
| Medicare Enrollment ID | O20240822000189 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780466532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Jennifer Pean-winston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811643422 PECOS PAC ID: 4789034943 Enrollment ID: I20240822000137 |
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