Provider Demographics
NPI:1548613987
Name:SEQUENCE TO HEALTH
Entity Type:Organization
Organization Name:SEQUENCE TO HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEARS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:770-855-3229
Mailing Address - Street 1:3790 PLEASANT HILL ROAD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5147
Mailing Address - Country:US
Mailing Address - Phone:770-855-3229
Mailing Address - Fax:
Practice Address - Street 1:3790 PLEASANT HILL ROAD
Practice Address - Street 2:SUITE 260
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5147
Practice Address - Country:US
Practice Address - Phone:770-855-3229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-21
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty