Provider Demographics
NPI:1780829002
Name:DISCOVER WELLNESS, LLC
Entity Type:Organization
Organization Name:DISCOVER WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DONALDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:678-398-7338
Mailing Address - Street 1:1025 ROSE CREEK DR
Mailing Address - Street 2:SUITE 340
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-6797
Mailing Address - Country:US
Mailing Address - Phone:678-398-7338
Mailing Address - Fax:
Practice Address - Street 1:1025 ROSE CREEK DR
Practice Address - Street 2:SUITE 340
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-6797
Practice Address - Country:US
Practice Address - Phone:678-398-7338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-16
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA005792111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1417089368OtherMICHAEL R. DONALDSON, DC