| Renew Wellness Inc | |
|
11348 Tara Blvd Ste 100 Hampton GA 30228-6277 | |
| (678) 466-6424 | |
| (678) 466-6464 |
| Full Name | Renew Wellness Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 11348 Tara Blvd, Hampton, Georgia |
| Authorized Official Name and Position | Stacy Petit (OWNER) |
| Authorized Official Contact | 6786154029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Wellness Inc 11348 Tara Blvd Ste 100 Hampton GA 30228-6277 Ph: (678) 466-6424 | Renew Wellness Inc 11348 Tara Blvd Ste 100 Hampton GA 30228-6277 Ph: (678) 466-6424 |
| NPI Number | 1053779058 |
|---|---|
| Provider Enumeration Date | 02/04/2016 |
| Last Update Date | 02/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053779058 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 048349 (Georgia) | Primary |
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