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Organization

SOQUE SURGICAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNY ONKHAM (OFFICE MANAGER)
(706) 754-8339
Entity
Organization

Contact information

Practice address
855 AUSTIN DRIVE, DOMOREST, GA 30535
(706) 754-8339
(706) 754-8460
Mailing address
PO BOX 1660, CLARKESVILLE, GA 30523-0028
(706) 754-8339
(706) 754-8460

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
53989
GA

Other

Enumeration date
02/07/2008
Last updated
02/07/2008
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