Organization
ANGELITE FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NNAEMEKA (CHUCK) P CHUKKA PAA-C (ADMINISTRATOR)
(678) 485-3063
Entity
Organization
Contact information
Practice address
312 W 8TH ST, WEST POINT, GA 31833-1539
(706) 616-6223
(877) 898-1518
Mailing address
8491 HOSPITAL DR, NUMBER 176, DOUGLASVILLE, GA 30134-2412
(678) 464-7284
(770) 703-1553
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
261QR1300X
GA
Other
Enumeration date
06/28/2010
Last updated
12/31/2015
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