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Organization
TRADITIONAL FAMILY HEALTHCARE
Active
Organization
TRADITIONAL FAMILY HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN O REESE M.D. (OWNER)
(478) 935-9055
Entity
Organization
Contact information
Practice address
202 WATERCRESS DR, LIZELLA, GA 31052-3636
(478) 935-9055
Mailing address
PO BOX 575, LIZELLA, GA 31052-0575
(478) 935-9055
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
044319
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00083794E
—
GA
Enumeration date
07/16/2008
Last updated
09/03/2010
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