| Riverstone Medical Campus | |
|
101 Riverstone Vis Suite 101 Blue Ridge GA 30513-6648 | |
| (706) 632-4400 | |
| (706) 632-4404 |
| Full Name | Riverstone Medical Campus |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 101 Riverstone Vis, Blue Ridge, Georgia |
| Authorized Official Name and Position | Raymond Tidman (DIRECTOR) |
| Authorized Official Contact | 7066324400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Riverstone Medical Campus 101 Riverstone Vis Suite 101 Blue Ridge GA 30513-6648 Ph: (706) 632-4400 | Riverstone Medical Campus 101 Riverstone Vis Suite 101 Blue Ridge GA 30513-6648 Ph: (706) 632-4400 |
| NPI Number | 1013961424 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013961424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW002589 (Georgia) | Primary |
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