| We Are Back On Track Llc | |
|
1015 Tyrone Rd Ste 710 Tyrone GA 30290-2455 | |
| (770) 468-3326 | |
| Not Available |
| Full Name | We Are Back On Track Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1015 Tyrone Rd Ste 710, Tyrone, Georgia |
| Authorized Official Name and Position | Lysha Wood (OWNER) |
| Authorized Official Contact | 7704683326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| We Are Back On Track Llc 1015 Tyrone Rd Ste 710 Tyrone GA 30290-2455 Ph: (770) 468-3326 | We Are Back On Track Llc 1015 Tyrone Rd Ste 710 Tyrone GA 30290-2455 Ph: (770) 468-3326 |
| NPI Number | 1205204294 |
|---|---|
| Provider Enumeration Date | 09/08/2015 |
| Last Update Date | 05/03/2024 |
| Certification Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205204294 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC 007168 (Georgia) | Primary |
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