Provider Demographics
NPI:1821832700
Name:AESTHETICS & WELLNESS OF COLUMBUS, LLC
Entity type:Organization
Organization Name:AESTHETICS & WELLNESS OF COLUMBUS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-322-9313
Mailing Address - Street 1:2522 WARM SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904-5640
Mailing Address - Country:US
Mailing Address - Phone:706-322-9313
Mailing Address - Fax:706-322-9314
Practice Address - Street 1:2522 WARM SPRINGS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-5640
Practice Address - Country:US
Practice Address - Phone:706-322-9313
Practice Address - Fax:706-322-9314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty