Organization
ADVANCE MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYRONDA WHEATON (LPN)
(205) 463-6230
Entity
Organization
Contact information
Practice address
117 ROCKY RIDGE ST, CARROLLTON, AL 35447-2139
(205) 463-6230
Mailing address
PO BOX 222, CARROLLTON, AL 35447-0222
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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