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Organization
AVILYS, LLC
Active
Organization
AVILYS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK SHANE MOBLEY (PRESIDENT)
(855) 228-4597
Entity
Organization
Contact information
Practice address
2300 NORTHSIDE XING, STE B, MACON, GA 31210-2254
(855) 228-4597
(855) 428-4597
Mailing address
2300 NORTHSIDE XING, STE B, MACON, GA 31210-2254
(855) 228-4597
(855) 428-4597
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
—
NULL
293D00000X
Physiological Laboratory
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
Other
Enumeration date
07/10/2014
Last updated
02/02/2023
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