Organization
HEALING OAKS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL B VICKERY MD (OWNER/MANAGER)
(770) 378-0328
Entity
Organization
Contact information
Practice address
203 OAKSIDE LN STE C, CANTON, GA 30114-6407
(770) 604-1930
(770) 604-1929
Mailing address
PO BOX 5554, CANTON, GA 30114-0290
(770) 378-0328
(770) 604-1929
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
773092643F
—
GA
Enumeration date
03/22/2021
Last updated
03/22/2021
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