Provider Demographics
NPI:1780466532
Name:WELLTOUCH WELLNESS CLINIC LLC
Entity type:Organization
Organization Name:WELLTOUCH WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHARLENE
Authorized Official - Last Name:PEAN-WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:404-409-9439
Mailing Address - Street 1:3685 WARWICK WAY
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30039-8069
Mailing Address - Country:US
Mailing Address - Phone:404-409-9439
Mailing Address - Fax:
Practice Address - Street 1:252 SHANNON WAY
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-3793
Practice Address - Country:US
Practice Address - Phone:404-409-9439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center