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General NPI Number Information
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NPI Number | 1447474689
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Entity Type | Organization
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Legal Business Name | WELLNESS ONE MARIETTA
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2727 CANTON ROAD SUITE # 520
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City | MARIETTA
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State | GA
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Zip | 30066
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Country | US
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Telephone | 770-795-0506
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Fax | 770-795-0392
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Provider Business Mailing Address
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Address Line | PO BOX 672542
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City | MARIETTA
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State | GA
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Zip | 30006-2542
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Country | US
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Telephone | 770-795-0506
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Fax | 770-795-0392
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. DANIEL LYNN MIDDLETON
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Credential |
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Telephone | 770-850-0857
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | GA6328
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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 | GA5936
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 024767
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License Number State | GA
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