NPI 1063061315
Wellstreet of Georgia PC
Practice location
- Address
- 1280 Dogwood Dr SE, Conyers, GA 30013-5046
- Phone
- (404) 994-4662
- Fax
- (404) 994-4663
- Mailing address
- 3350 Riverwood Pkwy SE STE 1850, Atlanta, GA 30339-3300
Authorised official
- Name
- Keesha D. Pinacle
- Title
- Cred Mgr
- Phone
- (770) 809-3036
Registered specialties
Non-Pharmacy Dispensing Site
Primary
Registry record
- NPI
- 1063061315
- Entity type
- Organization
- NPI issued
- 10 Sep 2019
- Record last updated
- 10 Sep 2019
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.