Organization
SOUTHERN NEUROLOGY, PHYSICAL MEDICINE & REHABILITATION, LLC
Active
Other names
Southern Neurology, Physical Medicine & Rehabilitation, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY KEITH BUSSEY (PRACTICE MANAGER)
(229) 292-2074
Entity
Organization
Contact information
Practice address
4913 LANES POND RD, VALDOSTA, GA 31601-1537
(229) 292-2074
Mailing address
4913 LANES POND RD, VALDOSTA, GA 31601-1537
(229) 292-2074
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
03/24/2020
Last updated
03/24/2020
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