Individual
JAMES DEWAYNE WILLAFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LDO
Contact information
Practice address
3274 INNER PERIMETER RD, VALDOSTA, GA 31602-1073
(229) 590-8680
Mailing address
9126 MOULTRIE HWY, QUITMAN, GA 31643-4533
(229) 590-8680
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1550
GA
156FX1800X
Optician
6077
FL
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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