Organization
WARE WEIGHT LOSS CENTER, LLC
Active
Other names
Ware Medical and Weight Loss Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK TATUM PA (PHYSICIAN ASSISTANT (PARTNER))
(912) 285-9990
Entity
Organization
Contact information
Practice address
1710 1/2 ALICE ST, WAYCROSS, GA 31501-5216
(912) 285-9990
(912) 283-9797
Mailing address
1710 1/2 ALICE ST, WAYCROSS, GA 31501-5216
(912) 285-9990
(912) 283-9797
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
GA
Other
Enumeration date
07/11/2015
Last updated
10/19/2015
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