Organization
EARLY MILLER EMPLOYMENT (NOW)
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID BARANKO (CFO)
(229) 430-0416
Entity
Organization
Contact information
Practice address
302 DAMASCUS STREET, BLAKELY, GA 39823-3346
(229) 723-4325
Mailing address
302 DAMASCUS STREET, BLAKELY, GA 39823-3346
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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