Healthcare Provider Details

I. General information

NPI: 1184819880
Provider Name (Legal Business Name): WINNER WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 GREEN ST NE
GAINESVILLE GA
30501-3322
US

IV. Provider business mailing address

746 GREEN ST NE
GAINESVILLE GA
30501-3322
US

V. Phone/Fax

Practice location:
  • Phone: 770-536-6600
  • Fax: 770-536-3923
Mailing address:
  • Phone: 770-536-6600
  • Fax: 770-536-3923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number9057
License Number StateGA

VIII. Authorized Official

Name: DR. JOHN FREDRICK WINNER
Title or Position: CHIROPRACTOR
Credential: D,C.
Phone: 770-536-6600