Individual
JOSEPH SAM HADAWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4660 RIVERSIDE PARK BLVD, MACON, GA 31210-1395
(478) 474-0240
(478) 475-1340
Mailing address
120 OSIGIAN BLVD # B, SUITE 100, WARNER ROBINS, GA 31088-7880
(478) 953-5358
(478) 953-5340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001243
GA
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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