Organization
MARY LOU'S GARDEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIMEE MARIE WILLIAMS RN, CFM (PRESIDENT)
(706) 310-7175
Entity
Organization
Contact information
Practice address
10 S BARNETT SHOALS RD, SUITE C., WATKINSVILLE, GA 30677-6711
(706) 310-7175
(706) 310-7176
Mailing address
PO BOX 1723, WATKINSVILLE, GA 30677-0034
(706) 310-7175
(706) 310-7176
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
INV-8-06-988
GA
Other
Enumeration date
06/05/2009
Last updated
06/30/2020
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