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General NPI Number Information
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NPI Number | 1174409403
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Entity Type | Organization
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Legal Business Name | EVERTREE WELLNESS, LLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 770 OLD ROSWELL PL STE I500
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City | ROSWELL
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State | GA
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Zip | 30076-8654
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Country | US
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Telephone | 770-843-5352
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Fax |
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Provider Business Mailing Address
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Address Line | 707 DEERWOOD DR
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6321
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Country | US
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Telephone | 770-843-5352
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AVION BAILEY
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Credential | BSN-RN, MSN-FNP
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Telephone | 678-304-7242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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