Provider Demographics
NPI:1962960963
Name:RAINBOW WELLNESS CENTER INC
Entity type:Organization
Organization Name:RAINBOW WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DA
Authorized Official - Middle Name:
Authorized Official - Last Name:YAN
Authorized Official - Suffix:
Authorized Official - Credentials:OMD, LAC
Authorized Official - Phone:404-789-5992
Mailing Address - Street 1:4897 BUFORD HWY STE 223
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-3669
Mailing Address - Country:US
Mailing Address - Phone:404-789-5992
Mailing Address - Fax:678-224-5186
Practice Address - Street 1:4897 BUFORD HWY STE 223
Practice Address - Street 2:
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341-3669
Practice Address - Country:US
Practice Address - Phone:404-789-5992
Practice Address - Fax:678-224-5186
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-08
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty