| Neo Holistic Health Llc | |
|
1747 Boulder Walk Ln Se Atlanta GA 30316-3990 | |
| (404) 423-8158 | |
| Not Available |
| Full Name | Neo Holistic Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1747 Boulder Walk Ln Se, Atlanta, Georgia |
| Authorized Official Name and Position | Latonia Michelle Trawick (OWNER/EMPLOYEE) |
| Authorized Official Contact | 4044238158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neo Holistic Health Llc 1747 Boulder Walk Ln Se Atlanta GA 30316-3990 Ph: (404) 423-8158 | Neo Holistic Health Llc 1747 Boulder Walk Ln Se Atlanta GA 30316-3990 Ph: (404) 423-8158 |
| NPI Number | 1972193142 |
|---|---|
| Provider Enumeration Date | 01/21/2021 |
| Last Update Date | 01/21/2021 |
| Medicare PECOS PAC ID | 2466869268 |
|---|---|
| Medicare Enrollment ID | O20210323001153 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972193142 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Latonia Michelle Trawick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912310269 PECOS PAC ID: 1850513383 Enrollment ID: I20141117000995 |
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