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General NPI Number Information
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NPI Number | 1407764251
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Entity Type | Organization
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Legal Business Name | MEDICAL WELLNESS CARE LLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 2471 EBENEZER RD SE
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City | CONYERS
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State | GA
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Zip | 30094-2543
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Country | US
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Telephone | 404-939-7737
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 376
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City | CONYERS
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State | GA
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Zip | 30012-0376
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Country | US
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Telephone | 404-939-7737
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. MELISSA W. CLEMENTS
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Credential | RN
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Telephone | 470-717-7846
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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