Organization
ROCKDALE BLACKHAWK LLC
Active
Other names
Little River Healthcare Speciality Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY P MADISON (CEO)
(512) 446-4500
Entity
Organization
Contact information
Practice address
1512 LEANDER RD, GEORGETOWN, TX 78628-8801
(512) 948-7611
Mailing address
1512 LEANDER RD, GEORGETOWN, TX 78628-8801
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
05/14/2014
Last updated
05/14/2014
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