Individual
MS. MARENE DENISE CHAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1731 JIMMY CARTER DR, VALDOSTA, GA 31602-7187
(912) 550-3928
Mailing address
1731 JIMMY CARTER DR, VALDOSTA, GA 31602-7187
(912) 550-3928
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
09/15/2021
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