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General NPI Number Information
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NPI Number | 1760889109
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Entity Type | Organization
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Legal Business Name | NEW VISION HEALTH AND WELLNESS
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 3257 LIBERTY COMMONS DR NW
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City | KENNESAW
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State | GA
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Zip | 30144-2322
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Country | US
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Telephone | 770-316-8321
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Fax | 678-403-2120
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Provider Business Mailing Address
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Address Line | 3257 LIBERTY COMMONS DR NW
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City | KENNESAW
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State | GA
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Zip | 30144-2322
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Country | US
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Telephone | 770-316-8321
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Fax | 678-403-2120
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Authorized Official
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Title or Position | OWNER/DIRECTOR OF REHABILITATION
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Name | MS. ANDREA JOAN ROMINE
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Credential | R.N.
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Telephone | 770-316-8321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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