Organization
GREG WOLF
Active
Other names
Greg
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY DAVID WOLF RN (OWNER)
(904) 571-5678
Entity
Organization
Contact information
Practice address
1513 CHATHAM CT, ST AUGUSTINE, FL 32092-5050
(904) 571-5678
Mailing address
1513 CHATHAM CT, ST AUGUSTINE, FL 32092-5050
(904) 571-5678
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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