Organization
INITIUM VITAE
Active
Organization
INITIUM VITAE
Active
Other names
FTHC
Organization subpart
No
Provider details
NPI number
Authorized official
DESHAUN INGERSOLL-BROWN (ADMINISTRATOR)
(470) 815-1138
Entity
Organization
Contact information
Practice address
6254 WARM SPRINGS RD APT D6, COLUMBUS, GA 31909-9144
(470) 652-1202
(706) 671-6317
Mailing address
6254 WARM SPRINGS RD APT D6, COLUMBUS, GA 31909-9144
(470) 652-1202
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2025
Last updated
09/17/2025
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