Individual
MAMIE LEE GILLIARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3503 OSAGE CT, AUGUSTA, GA 30906-4533
(706) 284-2441
Mailing address
3503 OSAGE CT, AUGUSTA, GA 30906-4533
(706) 284-2441
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
LCB20140000963
GA
Other
Enumeration date
07/03/2014
Last updated
07/03/2014
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