Organization
T E ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER T EDALGO CRNA (SOLE MEMBER)
(478) 257-6923
Entity
Organization
Contact information
Practice address
1854 FORSYTH ST, SUITE 3, MACON, GA 31201-1169
(478) 257-6923
Mailing address
220 PROVIDENCE BLVD, MACON, GA 31210-7551
(478) 257-6923
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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