Individual
DULCE X VINAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
503 S GRANT ST, FITZGERALD, GA 31750-3313
(229) 424-7000
(229) 424-7074
Mailing address
503 S GRANT ST, FITZGERALD, GA 31750-3313
(229) 424-7000
(229) 424-7074
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/14/2011
Last updated
06/14/2011
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