Individual
MR. WENDA L COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
713 ALBANY ST, BRUNSWICK, GA 31520-8058
(912) 571-6942
Mailing address
713 ALBANY ST, BRUNSWICK, GA 31520-8058
(912) 571-6942
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
81116
GA
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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