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General NPI Number Information
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NPI Number | 1235890070
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Entity Type | Organization
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Legal Business Name | ASSURANCE WELLNESS LLC
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Dates
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Enumeration Date | 01/04/2022
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Last Update Date | 01/04/2022
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Provider Practice Location Address
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Address Line | 69 SAINT PAUL RD
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City | GARFIELD
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State | GA
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Zip | 30425-3823
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Country | US
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Telephone | 404-376-4504
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Fax |
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Provider Business Mailing Address
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Address Line | 976 KATHRYN CT
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City | AUSTELL
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State | GA
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Zip | 30168-6204
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Country | US
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Telephone | 404-376-4504
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/OWNER
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Name | DR. SHANTIA WARREN
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Credential | DPT
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Telephone | 404-376-4504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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