Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-02-01
- Last updated
- 2022-02-28
Licenses
The registry row did not include a license.
Location
- Practice location
- 114 CANAL ST STE 703
- City
- POOLER GA
- Postal code
- 313224291
- Phone
- 912-988-3323
Organization contact
- Name
- MELISSA ROBITAILLE
- Title
- Owner
- Phone
- 9129883323
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
The OIG NPI list is not in this build yet. Confirm on OIG's search.
Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.