Organization
IMMEDIATE CARE OF ROME #1, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT WILDMON (COO)
(706) 354-1036
Entity
Organization
Contact information
Practice address
18 RIVERBEND DR SW, SUITE 230, ROME, GA 30161-6013
(706) 291-2999
(706) 291-4006
Mailing address
18 RIVERBEND DR SW, SUITE 230, ROME, GA 30161-6013
(706) 291-2999
(706) 291-4006
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN113917
GA
Other
Enumeration date
02/11/2010
Last updated
02/11/2010
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