Organization
MIR HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WAGNER FNP (PROVIDER)
(912) 616-8033
Entity
Organization
Contact information
Practice address
321 COMMERCIAL DR, SAVANNAH, GA 31406-3662
(912) 616-8033
(912) 216-3436
Mailing address
18 S CROMWELL RD, SAVANNAH, GA 31410-4421
(912) 616-8033
(912) 216-3436
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/12/2023
Last updated
07/05/2023
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