Graduated: 2023
NPI: 1942898473
Practice Locations (2)
WELLSTREET OF GEORGIA PC
4475 W VILLAGE PKWY
ELLENWOOD, GA 302942869
7705077950
PEACHTREE IMMEDIATE CARE FP, LLC
2005 MOUNT ZION RD
MORROW, GA 302603313
7709195250
Source: CMS National Downloadable File, September 2026.