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General NPI Number Information
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NPI Number | 1508593229
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Entity Type | Organization
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Legal Business Name | EVER WELLNESS CENTER, INC
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 1230 JOHNSON FERRY PL BLDG2 STE I-20
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City | MARIETTA
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State | GA
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Zip | 30068-2048
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Country | US
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Telephone | 678-273-2472
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Fax | 470-407-6985
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Provider Business Mailing Address
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Address Line | 1230 JOHNSON FERRY PL BLDG2 STE I-20
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City | MARIETTA
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State | GA
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Zip | 30068-2048
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Country | US
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Telephone | 678-273-2472
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Fax |
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Authorized Official
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Title or Position | OWNER/HEALTH CARE PROVIDER
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Name | LI SHIJUN
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Credential | L.A.C, ACUPUNCTURIST
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Telephone | 678-273-2472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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