Organization
DESTINY MEDICAL SERVICES, INC
Active
Organization
DESTINY MEDICAL SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STACEY WILLINGHAM (CEO')
(404) 964-1474
Entity
Organization
Contact information
Practice address
2804 N OAK ST, VALDOSTA, GA 31602-5914
(229) 241-8925
(229) 241-9165
Mailing address
2774 N COBB PKWY, SUITE 109, #133, KENNESAW, GA 30152-3469
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
41426
GA
Other
Enumeration date
10/08/2013
Last updated
10/08/2013
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