Organization
MED STRIP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRANDI GORDON (CREDENTIALING ORGANIZER)
(706) 621-7561
Entity
Organization
Contact information
Practice address
121 TANGLEWOOD N, ROYSTON, GA 30662-3764
(706) 726-9612
Mailing address
PO BOX 52, FRANKLIN SPRINGS, GA 30639-0052
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
48250
GA
Other
Enumeration date
12/06/2014
Last updated
12/06/2014
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