Provider Demographics
NPI:1427394618
Name:HIGHLAND WELLNESS LLC
Entity Type:Organization
Organization Name:HIGHLAND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANET
Authorized Official - Middle Name:D
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-351-0043
Mailing Address - Street 1:240 N HIGHLAND AVE NE
Mailing Address - Street 2:SUITE F
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-5609
Mailing Address - Country:US
Mailing Address - Phone:770-351-0043
Mailing Address - Fax:888-270-6380
Practice Address - Street 1:240 N HIGHLAND AVE NE
Practice Address - Street 2:SUITE F
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-5609
Practice Address - Country:US
Practice Address - Phone:770-351-0043
Practice Address - Fax:888-270-6380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA19354208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty