Provider Demographics
NPI:1467329508
Name:TWTCW
Entity type:Organization
Organization Name:TWTCW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:POWELL
Authorized Official - Suffix:
Authorized Official - Credentials:OPERATING PARTNER
Authorized Official - Phone:470-990-6555
Mailing Address - Street 1:371 E PACES FERRY RD NE STE 125
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-4286
Mailing Address - Country:US
Mailing Address - Phone:470-312-2141
Mailing Address - Fax:470-312-2141
Practice Address - Street 1:371 E PACES FERRY RD NE STE 125
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-4286
Practice Address - Country:US
Practice Address - Phone:470-312-2141
Practice Address - Fax:470-312-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGroup - Single Specialty