Healthcare Provider Details

I. General information

NPI: 1639031990
Provider Name (Legal Business Name): FOUNDATION 33 WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 HUGH HOWELL RD STE 540
TUCKER GA
30084-4722
US

IV. Provider business mailing address

4500 HUGH HOWELL RD STE 540
TUCKER GA
30084-4722
US

V. Phone/Fax

Practice location:
  • Phone: 470-448-1190
  • Fax:
Mailing address:
  • Phone: 470-448-1190
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LARONDA WARD
Title or Position: OWNER
Credential: DC
Phone: 404-451-7222