Individual
WENDEL MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3121 PEACH ORCHARD RD, AUGUSTA, GA 30906-3521
(706) 792-5010
Mailing address
2653 CRANBROOK DR, HEPHZIBAH, GA 30815-6500
(706) 951-8206
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN083040
GA
Other
Enumeration date
06/26/2020
Last updated
06/26/2020
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