Healthcare Provider Details

I. General information

NPI: 1073829073
Provider Name (Legal Business Name): AYLO HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2010
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 HIGHWAY 155 N STE 100
MCDONOUGH GA
30252-4846
US

IV. Provider business mailing address

2200 HIGHWAY 155 N
MCDONOUGH GA
30252-4806
US

V. Phone/Fax

Practice location:
  • Phone: 678-490-0341
  • Fax: 678-490-0349
Mailing address:
  • Phone: 678-490-0341
  • Fax: 678-490-0349

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