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Organization
TRI-COUNTY CLINIC, INC.
Active
Organization
TRI-COUNTY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAN M BENNETT D.O. (OWNER)
(770) 464-4434
Entity
Organization
Contact information
Practice address
551 N CHEROKEE RD, SOCIAL CIRCLE, GA 30025-2887
(770) 464-4434
(770) 464-4424
Mailing address
551 N CHEROKEE RD, SOCIAL CIRCLE, GA 30025-2887
(770) 464-4434
(770) 464-4424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GA030580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000366638K
—
GA
Enumeration date
06/28/2007
Last updated
05/19/2008
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