East Main St | |
109 East Main St. Jeffersonville GA 31044 | |
(478) 751-4519 | |
Not Available |
Full Name | East Main St |
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Speciality | Community/behavioral Health |
Location | 109 East Main St., Jeffersonville, Georgia |
Authorized Official Name and Position | Emily Beth Tyler (CFO) |
Authorized Official Contact | 4787523231 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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East Main St 109 East Main St. Jeffersonville GA 31044 Ph: (478) 751-4519 | East Main St 109 East Main St. Jeffersonville GA 31044 Ph: (478) 751-4519 |
NPI Number | 1033279021 |
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Provider Enumeration Date | 12/11/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033279021 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (Georgia) | Primary |
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