Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 203 Tallapoosa St, Wadley, Alabama |
Authorized Official Name and Position | Richard W Daniel (ADMINISTRATOR) |
Authorized Official Contact | 2563572111 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
203 Tallapoosa St Wadley AL 36276 Ph: (256) 395-4157 | 203 Tallapoosa St Wadley AL 36276 Ph: (256) 395-4157 |
NPI Number | 1659396307 |
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Provider Enumeration Date | 07/13/2006 |
Last Update Date | 07/15/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659396307 | NPI | - | NPPES |
541003937 | Medicaid | AL |