Healthcare Provider Details

I. General information

NPI: 1851625370
Provider Name (Legal Business Name): HOLISTIC APPROACH WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2009
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5744 AUSTELL POWDER SPRINGS RD
AUSTELL GA
30106-3231
US

IV. Provider business mailing address

5744 AUSTELL POWDER SPRINGS RD
AUSTELL GA
30106-3231
US

V. Phone/Fax

Practice location:
  • Phone: 678-558-3968
  • Fax: 678-623-0298
Mailing address:
  • Phone: 678-558-3968
  • Fax: 678-623-0298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License NumberN/A
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State

VIII. Authorized Official

Name: DR. JOY EDWARDS
Title or Position: OWNER
Credential:
Phone: 678-558-3968