Individual
CLARENCE WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
171 STERLING RIDGE DR, RIVERDALE, GA 30274-4637
(404) 202-5098
Mailing address
171 STERLING RIDGE DR, RIVERDALE, GA 30274-4637
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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