Individual
AMELIA RUTH MALCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1075 S MAIN ST, SUITE 100, MADISON, GA 30650-2033
(706) 752-0322
(706) 752-0325
Mailing address
PO BOX 209, MADISON, GA 30650-0209
(706) 752-0322
(706) 752-0325
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
171386
GA
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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