Organization
VITA O2 INC.
Active
Organization
VITA O2 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERE HYLAND (OWNER)
(706) 265-8952
Entity
Organization
Contact information
Practice address
104 COLONY PARK DR, CUMMING, GA 30040-2792
(706) 265-8952
(706) 265-8953
Mailing address
90 CHAPPELL RD, DAWSONVILLE, GA 30534-7497
(706) 265-8952
(706) 265-8953
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
10/16/2007
Last updated
10/16/2007
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