Organization
SOUTHERN CHOICES OF THE COAST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYLER DORN (ADMINISTRATOR)
(608) 772-0830
Entity
Organization
Contact information
Practice address
712 N LAUREL ST STE 200B, SPRINGFIELD, GA 31329-6830
(608) 772-0830
Mailing address
712 N LAUREL ST STE 200B, SPRINGFIELD, GA 31329-6830
(608) 772-0830
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/10/2024
Last updated
10/10/2024
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