Individual
THERESA PATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4664 VIENNA CHURCH RD, VALDOSTA, GA 31605-5524
(229) 333-8028
Mailing address
4664 VIENNA CHURCH RD, VALDOSTA, GA 31605-5524
(229) 333-8028
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
PCH008346
GA
Other
Enumeration date
06/17/2024
Last updated
06/17/2024
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