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Organization
SOUTHERN SKIN & WELLNESS CENTER
Active
Organization
SOUTHERN SKIN & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ANTHONY AMBROZIC MD (PRESIDENT)
(229) 242-9310
Entity
Organization
Contact information
Practice address
3321 N VALDOSTA RD STE B, VALDOSTA, GA 31602-1685
(229) 242-9310
(229) 242-9714
Mailing address
3321 N VALDOSTA RD STE B, VALDOSTA, GA 31602-1685
(229) 242-9310
(229) 242-9714
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/05/2009
Last updated
03/16/2015
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