Healthcare Provider Details

I. General information

NPI: 1932027372
Provider Name (Legal Business Name): WELLSTREET OF GEORGIA PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 HILLCREST PKWY STE 1
DUBLIN GA
31021-4259
US

IV. Provider business mailing address

1006 HILLCREST PKWY STE 1
DUBLIN GA
31021-4259
US

V. Phone/Fax

Practice location:
  • Phone: 478-354-4240
  • Fax: 478-354-4245
Mailing address:
  • Phone: 478-354-4240
  • Fax: 478-354-4245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: KATIE MONS
Title or Position: DISTRICT MANAGER
Credential:
Phone: 678-414-2824