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General NPI Number Information
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NPI Number | 1235590472
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Entity Type | Organization
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Legal Business Name | VALLEY WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 03/16/2016
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | 327 DAHLONEGA STREET, BLDG 1200
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-887-2303
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Fax | 678-807-7840
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Provider Business Mailing Address
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Address Line | 327 DAHLONEGA STREET, BLDG 1200
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City | CUMMING
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State | GA
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Zip | 30040
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Country | US
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Telephone | 770-887-2303
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Fax | 678-807-7840
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DR. CLAYTON P WILLIAMS
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Credential | DC
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Telephone | 770-887-2303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 44237
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | GA
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