Provider Demographics
NPI:1760889109
Name:NEW VISION HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:NEW VISION HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR OF REHABILITATION
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:ROMINE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-316-8321
Mailing Address - Street 1:3257 LIBERTY COMMONS DR NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-2322
Mailing Address - Country:US
Mailing Address - Phone:770-316-8321
Mailing Address - Fax:678-403-2120
Practice Address - Street 1:3257 LIBERTY COMMONS DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-2322
Practice Address - Country:US
Practice Address - Phone:770-316-8321
Practice Address - Fax:678-403-2120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation