Provider Demographics
NPI:1245052208
Name:SMART CARE CLINIC & WELLNESS SPA LLC
Entity type:Organization
Organization Name:SMART CARE CLINIC & WELLNESS SPA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:678-753-7800
Mailing Address - Street 1:2254 HIGHWAY 42 N
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-4734
Mailing Address - Country:US
Mailing Address - Phone:678-753-7800
Mailing Address - Fax:
Practice Address - Street 1:2254 HIGHWAY 42 N
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4734
Practice Address - Country:US
Practice Address - Phone:678-753-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center