Organization
AUGUSTA CENTRE FOR DERMATOLOGY & SKIN RENEWAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNE M LOEBL MD (OWNER)
(706) 447-3909
Entity
Organization
Contact information
Practice address
3614 J DEWEY GRAY CIR, STE B, AUGUSTA, GA 30909-6602
(706) 447-3909
Mailing address
3614 J DEWEY GRAY CIR, STE B, AUGUSTA, GA 30909-6602
(706) 447-3909
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
022436
GA
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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