Healthcare Provider Details

I. General information

NPI: 1013290550
Provider Name (Legal Business Name): WELLNESS FIRST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 01/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

641 HOSPITAL RD SUITE 4
COMMERCE GA
30529-1155
US

IV. Provider business mailing address

641 HOSPITAL RD SUITE 4
COMMERCE GA
30529-1155
US

V. Phone/Fax

Practice location:
  • Phone: 706-335-2777
  • Fax: 706-335-2788
Mailing address:
  • Phone: 706-335-2777
  • Fax: 706-335-2788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number043107
License Number StateGA

VIII. Authorized Official

Name: DR. VERONICA MICHELLE PATTERSON
Title or Position: PHYSICIAN
Credential: MD
Phone: 706-335-2777