| Campbell Trail Llc | |
|
430 Sir Winston Ct Jonesboro GA 30238-4561 | |
| (770) 256-5238 | |
| Not Available |
| Full Name | Campbell Trail Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 430 Sir Winston Ct, Jonesboro, Georgia |
| Authorized Official Name and Position | Joshua Miller (OWNER) |
| Authorized Official Contact | 7702565238 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Campbell Trail Llc 430 Sir Winston Ct Jonesboro GA 30238-4561 Ph: () - | Campbell Trail Llc 430 Sir Winston Ct Jonesboro GA 30238-4561 Ph: (770) 256-5238 |
| NPI Number | 1023888039 |
|---|---|
| Provider Enumeration Date | 01/02/2024 |
| Last Update Date | 01/17/2024 |
| Certification Date | 01/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023888039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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