Organization · NPI-2

100 Percent Nutrition LLC

Clinic/Center, Health Services · Gainesville, GA

NPI number1851909857
StatusActive
Last updated in NPPESJul 16, 2020

Details

NPI
1851909857
Entity type
Organization (NPI-2)
Legal business name
100 Percent Nutrition LLC
Organization subpart
No
Enumeration date
Jul 16, 2020
Certification date
Jul 16, 2020
Last updated
Jul 16, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QH0100X Clinic/Center, Health Services––Yes

Practice location

8425 Waldrip Rd
Gainesville, GA 30506-5774

Phone 678-815-4551

Mailing address

8425 Waldrip Rd
Gainesville, GA 30506-5774

Phone 678-815-4551

Other practice locations

11030 Medlock Bridge Rd Ste 230
Johns Creek, GA 30097-3504

Phone 678-694-1113

5400 Laurel Springs Pkwy Ste 802
Suwanee, GA 30024-6096

Phone 404-808-1161

Authorized official

Katie Potts-Carr
Owner
6788154551

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