Organization
THE MIGRAINE AND SPINE CLINIC OF VALDOSTA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN SULE M.D. (MANAGER)
(229) 333-9838
Entity
Organization
Contact information
Practice address
3315 N VALDOSTA RD, SUITE A, VALDOSTA, GA 31602-1107
(229) 333-9838
(229) 333-9839
Mailing address
3315 N VALDOSTA RD, SUITE A, VALDOSTA, GA 31602-1107
(229) 333-9838
(229) 333-9839
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
60329
GA
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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