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NPI Code Detail

MEDICARE: INTROSPEKTS WELLNESS GROUP

MEDICARE: INTROSPEKTS WELLNESS GROUP
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
1261QM1300XMulti-Specialty Clinic/Center
2104100000XSocial Worker
3225700000XMassage Therapist
4208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1801151410
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTROSPEKTS WELLNESS GROUP
Provider Business Mailing Address
First Line : 4300 PACES FERRY RD SE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5714
Country : US
Telephone Number : 770-948-8000
Fax Number :
Provider Business Practice Location Address
First Line : 4300 PACES FERRY RD SE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5714
Country : US
Telephone Number : 770-948-8000
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : MARYANN WILSON
Credential :
Telephone Number : 770-948-8000
Provider Enumeration Date : 07/10/2012
Last Update Date : 10/21/2025

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Directions to “INTROSPEKTS WELLNESS GROUP ” Practice Location

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