Organization
EASTER SEALS MIDDLE GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE PEEBLES (PRESIDENT)
(478) 275-8850
Entity
Organization
Contact information
Practice address
604 KELLAM RD, DUBLIN, GA 31021-3377
(478) 275-8850
Mailing address
604 KELLAM RD, DUBLIN, GA 31021-3377
(478) 275-8850
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000722169A
—
GA
05
—
000722169B
—
GA
Enumeration date
04/26/2007
Last updated
09/12/2014
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