Organization
VALDOSTA HEALTH & WELLNESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACEY Q LIVINGSTON (OWNER)
(229) 469-6137
Entity
Organization
Contact information
Practice address
3328 BEMISS RD, VALDOSTA, GA 31605-7014
(229) 469-6137
(229) 469-6139
Mailing address
103 GOOD HOPE CIR, NAYLOR, GA 31641-3657
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/09/2014
Last updated
12/09/2014
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