Individual
PEGGY BENOIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
COMMANDER DDEAMC, CONNELLY HEATH CLINIC ATTN: MCHF-DFCM-CHC, FORT GORDON, GA 30905-5650
(706) 787-5143
Mailing address
444 MADISON STREET, GROVETOWN, GA 30813
(706) 910-0056
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
074112
GA
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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