| Wide Range Of Resources,iinc. | |
|
1776 N Jefferson St Ne Ste B Milledgeville GA 31061-2292 | |
| (478) 451-3112 | |
| (478) 451-0626 |
| Full Name | Wide Range Of Resources,iinc. |
|---|---|
| Speciality | Clinic/center |
| Location | 1776 N Jefferson St Ne Ste B, Milledgeville, Georgia |
| Authorized Official Name and Position | Frezalia L. Oliver (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4784513112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wide Range Of Resources,iinc. 1776 N Jefferson St Ne Ste B Milledgeville GA 31061-2292 Ph: (478) 451-3112 | Wide Range Of Resources,iinc. 1776 N Jefferson St Ne Ste B Milledgeville GA 31061-2292 Ph: (478) 451-3112 |
| NPI Number | 1861680696 |
|---|---|
| Provider Enumeration Date | 10/05/2007 |
| Last Update Date | 10/05/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861680696 | NPI | - | NPPES |
| 139858482A | Medicaid | GA | |
| 139858482B | Medicaid | GA | |
| GRP7368 | Other | GA | GROUP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | CSW000658 (Georgia) | Primary |
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