Organization
WOLF MEDICAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY HAROLD QUELLET (PRESIDENT)
(706) 233-8200
Entity
Organization
Contact information
Practice address
1715 MARTHA BERRY BLVD NW, ROME, GA 30165-1623
(706) 233-8200
(706) 233-8277
Mailing address
1715 MARTHA BERRY BLVD NW, ROME, GA 30165-1623
(706) 233-8200
(706) 233-8277
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
20115654383
GA
Other
Enumeration date
12/27/2010
Last updated
07/20/2011
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