Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bold Legacy Practice, LLC

Organization Clinic/Center · NPI 1972212116

Bold Legacy Practice, LLC is a Clinic/Center in Marietta, Georgia. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1401 Johnson Ferry Rd Ste 390
Marietta, GA 30062-9100
Phone: (470) 795-0047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urgent Care Clinic/Center (primary) Taxonomy 261QU0200X
Clinic/Center Taxonomy 261Q00000X

Record details

NPI number1972212116
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leia Dawson — Medical Director · (205) 907-5342
Other names American Family Care; Bold Legacy Management, Llc; Quadrivium Health Llc; Quadrivium Health Llc
NPI enumeratedNovember 16, 2022
Last updated in NPPESJanuary 5, 2024
Certification dateJanuary 5, 2024
Mailing address1117 Eagles Creek Way Nw, Acworth, GA 30101-4696

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