NPI 1336571454

Provectus Health Strategies, LLC

Organisation Exclusive Provider Organization Marietta, GA

Practice location

Address: 1640 Powers Ferry Rd SE Bldg 26-350, Marietta, GA 30067-1443
Phone: (912) 242-2284
Fax: (912) 882-9262

Authorised official

Name: Mack Wayne Bryson
Title: Ceo
Phone: (912) 242-2284

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X

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Registry record

NPI: 1336571454
Entity type: Organization
NPI issued: 31 Jul 2013
Record last updated: 31 Jul 2013

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.