Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2019-10-14
- Last updated
- 2021-05-25
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 601 N BELAIR SQ STE 2
- City
- EVANS GA
- Postal code
- 308094322
- Phone
- 706-619-1286
Organization contact
- Name
- JENNIFER MOORE
- Title
- Owner
- Phone
- 8643989418
Medicare
- PECOS
- No PECOS enrollment row matched 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.