NPI 1063787901

Port-A-Wellness LLC

Organisation Primary Care Clinic/Center East Point, GA

Practice location

Address: 1670 Washington Ave, East Point, GA 30344-4248
Phone: (678) 705-1691
Fax: (855) 289-7475

Authorised official

Name: Ramona Ann Minnis
Title: Medical Director
Phone: (678) 705-1691

Registered specialties

Primary Care Clinic/Center Primary

Ambulatory Health Care Facilities Taxonomy 261QP2300X Licence 042668 (GA)

Other Clinic/Center providers in Georgia →

Registry record

NPI: 1063787901
Entity type: Organization
NPI issued: 11 Mar 2012
Record last updated: 11 Mar 2012

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.