Individual
MR. HENRY SANTO INTILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
268 MOCK CEMETERY RD, BAINBRIDGE, GA 39817-6904
(800) 841-0858
(800) 841-0858
Mailing address
PO BOX 125, BAINBRIDGE, GA 39818-0125
(229) 246-1428
(229) 246-1428
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN123672NP
GA
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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