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General NPI Number Information
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NPI Number | 1710929914
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Entity Type | Organization
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Legal Business Name | AYLO HEALTH, LLC
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 3758 HIGHWAY 42 S
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City | LOCUST GROVE
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State | GA
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Zip | 30248-3653
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Country | US
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Telephone | 678-561-9430
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Fax | 770-914-1070
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Provider Business Mailing Address
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Address Line | 3333 RIVERWOOD PKWY SE STE 250
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City | ATLANTA
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State | GA
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Zip | 30339-3304
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Country | US
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Telephone | 770-914-0116
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Fax | 770-955-4278
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Authorized Official
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Title or Position | CEO
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Name | NICHOLAS WILLIAMS
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Credential |
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Telephone | 770-914-0116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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