NPI 1285017889

Optiwell MD Duluth LLC

Organisation Dietary Manager Duluth, GA

Practice location

Address: 4300 Pleasant Hill Rd Suite a, Duluth, GA 30096-6379
Phone: (678) 682-8734
Fax: (678) 682-8736
Mailing address: 8770 Colonial Pl, Duluth, GA 30097-6641

Authorised official

Name: Mary Bell Federico
Title: Owner
Phone: (404) 202-9433

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X Licence 61722 (GA)

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Registry record

NPI: 1285017889
Entity type: Organization
NPI issued: 1 Jul 2015
Record last updated: 1 Jul 2015

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.