Individual
JEFFREY WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 E HAVEN CT, KATHLEEN, GA 31047-3113
(478) 796-2007
Mailing address
104 E HAVEN CT, KATHLEEN, GA 31047-3113
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2017
Last updated
10/05/2017
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