Organization
SOUTHERN WEIGHT LOSS CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY BLITCH (MANAGER)
(912) 681-6334
Entity
Organization
Contact information
Practice address
628 MULLINS COLONY DR, EVANS, GA 30809-0579
(912) 681-6334
Mailing address
628 MULLINS COLONY DR, EVANS, GA 30809-0579
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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