Organization
GRACIOUSLY CLEAN
Active
Other names
Cancer treatment and counseling
Organization subpart
No
Provider details
NPI number
Authorized official
MADISON CHERRY (ADMINISTRATION)
(706) 619-0448
Entity
Organization
Contact information
Practice address
3407 JULIA AVE, AUGUSTA, GA 30906-4811
(706) 619-0449
Mailing address
3407 JULIA AVE, AUGUSTA, GA 30906-4811
(706) 619-0449
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
06/06/2024
Last updated
06/06/2024
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