| Judy B Bain | |
|
104 Harwell Ave Ste 236 Lagrange GA 30240-3132 | |
| (706) 885-0111 | |
| (706) 885-0607 |
| Full Name | Judy B Bain |
|---|---|
| Speciality | Clinic/center |
| Location | 104 Harwell Ave Ste 236, Lagrange, Georgia |
| Authorized Official Name and Position | Roxie Moton (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 7065946073 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Judy B Bain 104 Harwell Ave Ste 236 Lagrange GA 30240-3132 Ph: (706) 885-0111 | Judy B Bain 104 Harwell Ave Ste 236 Lagrange GA 30240-3132 Ph: (706) 885-0111 |
| NPI Number | 1679132922 |
|---|---|
| Provider Enumeration Date | 06/11/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679132922 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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