MEDICARE: JOSEPH KOMARA NBC-HWC, ACC

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
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1679363774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH KOMARA NBC-HWC, ACC

Provider Business Mailing Address
First Line	:	2064 TELFAIR CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-4193
Country	:	US
Telephone Number	:	347-752-2014
Fax Number	:

Provider Business Practice Location Address
First Line	:	2064 TELFAIR CIR NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-4193
Country	:	US
Telephone Number	:	347-752-2014
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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