Individual
MARY PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N ELM STREET, OCILLA, GA 31774
(229) 468-5748
Mailing address
303 N ELM STREET, OCILLA, GA 31774
(229) 468-5748
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
GA
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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