| Opt4wellness, Llc | |
|
2039 10th Ave Columbus GA 31901-1459 | |
| (706) 566-5764 | |
| (706) 566-4377 |
| Full Name | Opt4wellness, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2039 10th Ave, Columbus, Georgia |
| Authorized Official Name and Position | Stanley Wayne Himes (CEO/OWNER) |
| Authorized Official Contact | 7065804059 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Opt4wellness, Llc 350 Old Gate Rd Midland GA 31820-4777 Ph: (706) 580-4059 | Opt4wellness, Llc 2039 10th Ave Columbus GA 31901-1459 Ph: (706) 566-5764 |
| NPI Number | 1871087627 |
|---|---|
| Provider Enumeration Date | 06/15/2018 |
| Last Update Date | 06/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871087627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 33839 (Georgia) | Primary |
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