Provider Demographics
NPI:1841731700
Name:GOLDEN DAYS WELLNESS TRAINING LLC
Entity type:Organization
Organization Name:GOLDEN DAYS WELLNESS TRAINING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:SONEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:404-931-6242
Mailing Address - Street 1:9194 TARNWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-8447
Mailing Address - Country:US
Mailing Address - Phone:404-931-6242
Mailing Address - Fax:
Practice Address - Street 1:9194 TARNWOOD CIR
Practice Address - Street 2:
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-8447
Practice Address - Country:US
Practice Address - Phone:404-931-6242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-12
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT009520225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty