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104 Maxwell St Se Arlington GA 39813-8714 | |
(601) 849-6440 | |
(601) 849-1318 |
Full Name | |
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Speciality | Clinic/center |
Location | 104 Maxwell St Se, Arlington, Georgia |
Authorized Official Name and Position | Joseph Sylvester Mcnulty (CEO) |
Authorized Official Contact | 6018496440 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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104 Maxwell St Se Arlington GA 39813-8714 Ph: (601) 849-6440 | 104 Maxwell St Se Arlington GA 39813-8714 Ph: (601) 849-6440 |
NPI Number | 1154669554 |
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Provider Enumeration Date | 01/21/2013 |
Last Update Date | 01/21/2013 |
Identifier | Type | State | Issuer |
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1154669554 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | 049-667 (Georgia) | Primary |