Healthcare Provider Details

I. General information

NPI: 1437407236
Provider Name (Legal Business Name): WINDWARD HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 09/11/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 N POINT PKWY STE 101
ALPHARETTA GA
30005-4726
US

IV. Provider business mailing address

3225 NORTH POINT PKWY. , ALPHARETTA SUITE 101
ALPHARETTA GA
30005
US

V. Phone/Fax

Practice location:
  • Phone: 678-566-3030
  • Fax: 678-566-3035
Mailing address:
  • Phone: 678-566-3030
  • Fax: 678-566-3035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateGA

VIII. Authorized Official

Name: DR. JEFFREY L LUBOW
Title or Position: OWNER / CLINIC DIRECTOR
Credential: D.C.
Phone: 678-566-3030