Organization
MARK W. WIGHTMAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK W. WIGHTMAN (OWNER)
(706) 896-2872
Entity
Organization
Contact information
Practice address
1460 HIGHWAY 76 W, SUITE A, HIAWASSEE, GA 30546-2146
(706) 896-2872
(706) 896-2873
Mailing address
1460 HIGHWAY 76 W, SUITE A, HIAWASSEE, GA 30546-2146
(706) 896-2872
(706) 896-2873
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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