Individual
AL WYNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
605 S SLAPPEY BLVD, ALBANY, GA 31701-2611
(229) 347-6684
Mailing address
605 S SLAPPEY BLVD, ALBANY, GA 31701-2611
(229) 347-6684
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87-1770825
—
GA
Enumeration date
07/21/2021
Last updated
07/21/2021
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