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NPI Code Detail

MEDICARE: HIGHLAND WELLNESS LLC

MEDICARE: HIGHLAND WELLNESS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208D00000XGeneral Practice Physician19354GA

General Provider Information

NPI Number : 1427394618
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND WELLNESS LLC
Provider Business Mailing Address
First Line : 240 N HIGHLAND AVE NE
Second Line : SUITE F
City : ATLANTA
State : GA
Zip : 30307-5609
Country : US
Telephone Number : 770-351-0043
Fax Number : 888-270-6380
Provider Business Practice Location Address
First Line : 240 N HIGHLAND AVE NE
Second Line : SUITE F
City : ATLANTA
State : GA
Zip : 30307-5609
Country : US
Telephone Number : 770-351-0043
Fax Number : 888-270-6380
Authorized Official
Title or Position : BILLING MANAGER
Name : MRS. JANET D PALMER
Credential :
Telephone Number : 770-351-0043
Provider Enumeration Date : 12/17/2012
Last Update Date : 12/17/2012

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Directions to “HIGHLAND WELLNESS LLC ” Practice Location

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