Organization
DOWNTOWN MEDICAL CLINIC, LLC
Active
Other names
Glam Town Medical & Spa LLC
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA JOY COCHRAN (ADMINISTRATOR)
(478) 304-0606
Entity
Organization
Contact information
Practice address
124 W MADISON ST STE D, DUBLIN, GA 31021-5180
(478) 304-0606
(888) 375-3879
Mailing address
124 W MADISON ST STE D, DUBLIN, GA 31021-5180
(478) 304-0606
(888) 375-3879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208VP0000X
Pain Medicine Physician
—
—
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
Other
Enumeration date
06/05/2023
Last updated
07/09/2024
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