| It Is Well Healthcare, Llc | |
|
105 Village Walk Ste 277 Dallas GA 30132-5506 | |
| (678) 410-1781 | |
| Not Available |
| Full Name | It Is Well Healthcare, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 105 Village Walk Ste 277, Dallas, Georgia |
| Authorized Official Name and Position | Tara Howell (OWNER) |
| Authorized Official Contact | 6784101781 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| It Is Well Healthcare, Llc 105 Village Walk Ste 277 Dallas GA 30132-5506 Ph: (678) 410-1781 | It Is Well Healthcare, Llc 105 Village Walk Ste 277 Dallas GA 30132-5506 Ph: (678) 410-1781 |
| NPI Number | 1588269773 |
|---|---|
| Provider Enumeration Date | 12/03/2020 |
| Last Update Date | 12/03/2020 |
| Medicare PECOS PAC ID | 2163835638 |
|---|---|
| Medicare Enrollment ID | O20201231000330 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588269773 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tara Howell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982874053 PECOS PAC ID: 4688737844 Enrollment ID: I20090114000245 |
| Provider Name | Amy R Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063800548 PECOS PAC ID: 6305163056 Enrollment ID: I20150318000848 |
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