Organization
MARY LOU'S GARDEN, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAIMEE M DEAN RN (OWNER)
(706) 310-7175
Entity
Organization
Contact information
Practice address
10 S BARNETT SHOALS RD, SUITE C., WATKINSVILLE, GA 30677-2500
(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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
INV-8-06-988
GA
Other
Enumeration date
11/21/2007
Last updated
06/04/2009
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