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Organization

LIVE HEALTHY MD LLC

Active
Parent organization
LIVE HEALTHY MD LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LIVE HEALTHY MD LLC
Authorized official
DR. EDWARD H BOLAND MD (PHYSICIAN)
(706) 922-0440
Entity
Organization

Contact information

Practice address
3830 WASHINGTON RD, STE 17, AUGUSTA, GA 30907-5064
(706) 922-0440
(706) 922-0441
Mailing address
2101 CENTRAL AVE, AUGUSTA, GA 30904-6706
(706) 738-3359
(706) 738-0565

Taxonomy

Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
40826
GA

Other

Enumeration date
01/19/2012
Last updated
01/30/2012
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