OrganizationActive
Impact Wellness Center
NPI 1336671379 · Pain Medicine Physician · Decatur, GA
Provider details
- NPI number
- 1336671379
- Entity type
- Organization
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tefylon Cameron, Administrative Manager(678) 717-9299
- License
- GA050322 (GA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1989 N Williamsburg Dr
Suite E
Decatur, GA 30033-5998
Phone: (678) 717-9299
Fax: (404) 492-8885
Approximate (ZIP-level) locationGet directions
Mailing address
1989 N Williamsburg Dr
Decatur, GA 30033-5998
Registry dates
- Enumerated
- 2017-03-29
- Last updated
- 2017-03-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.