Individual
JENO R LIANGCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
989 SAINT SEBASTIAN WAY, AUGUSTA, GA 30912-2613
(706) 721-2171
Mailing address
1120 15TH ST # OR6000, AUGUSTA, GA 30912-0004
(706) 721-3813
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN293270
GA
Other
Enumeration date
04/01/2024
Last updated
07/19/2024
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