Healthcare Provider Details

I. General information

NPI: 1710929914
Provider Name (Legal Business Name): AYLO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3758 HIGHWAY 42 S
LOCUST GROVE GA
30248-3653
US

IV. Provider business mailing address

3333 RIVERWOOD PKWY SE STE 250
ATLANTA GA
30339-3304
US

V. Phone/Fax

Practice location:
  • Phone: 678-561-9430
  • Fax: 770-914-1070
Mailing address:
  • Phone: 770-914-0116
  • Fax: 770-955-4278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS WILLIAMS
Title or Position: CEO
Credential:
Phone: 770-914-0116