Individual
MR. WAYNE WASHINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
422 E PARK AVE, VALDOSTA, GA 31602-3036
(229) 247-5374
(229) 241-1981
Mailing address
422 E PARK AVE, VALDOSTA, GA 31602-3036
(229) 247-5374
(229) 241-1981
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
CO040287
GA
Other
Enumeration date
02/06/2013
Last updated
02/06/2013
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