Individual
THERESA ANN WAHIWE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6601 ZEBULON RD, MACON, GA 31220-7606
14784760805
Mailing address
6601 ZEBULON RD, MACON, GA 31220-7606
14784760805
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN240278
GA
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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