Organization
MR BREATH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT EDWIN BLACK (PARTNER)
(912) 674-5780
Entity
Organization
Contact information
Practice address
105 CHANDLER WAY, SAINT MARYS, GA 31558-2935
(912) 674-5780
Mailing address
105 CHANDLER WAY, SAINT MARYS, GA 31558-2935
(912) 674-5780
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
005083
GA
Other
Enumeration date
05/17/2010
Last updated
05/17/2010
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