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Organization

ORTHOPEDIC CENTER PC

Active
Other names
Optim Orthopedics
Organization subpart
No

Provider details

NPI number
Authorized official
TINA WRIGHT (PROVIDER ENROLLMENT SPECIALIST)
(912) 692-6926
Entity
Organization

Contact information

Practice address
125C VICTORY DR, SWAINSBORO, GA 30401-3234
(877) 827-6536
Mailing address
210 E DERENNE AVE, PROVIDER ENROLLMENT DEPT, SAVANNAH, GA 31405-6736
(912) 692-6926

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
GA

Other

Enumeration date
12/18/2013
Last updated
12/18/2013
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