OrganizationActive
Bold Legacy Practice, LLC
NPI 1972212116 · Urgent Care Clinic/Center · Marietta, GA
Provider details
- NPI number
- 1972212116
- Entity type
- Organization
- Primary specialty
- Urgent Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Leia Dawson, Medical Director(205) 907-5342
Specialties & taxonomies
Ambulatory Health Care Facilities
- Clinic/Center261Q00000X
Ambulatory Health Care Facilities
Practice location
1401 Johnson Ferry Rd Ste 390
Marietta, GA 30062-9100
Phone: (470) 795-0047
Approximate (ZIP-level) locationGet directions
Mailing address
1117 Eagles Creek Way Nw
Acworth, GA 30101-4696
Other names (DBA / former)
- Doing business as
- American Family Care
- Doing business as
- Bold Legacy Management, LLC
- Doing business as
- Quadrivium Health LLC
- Doing business as
- Quadrivium Health LLC
Registry dates
- Enumerated
- 2022-11-16
- Last updated
- 2024-01-05
- Certified
- 2024-01-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.