Organization
OPT4WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY WAYNE HIMES MD (CEO/OWNER)
(706) 580-4059
Entity
Organization
Contact information
Practice address
2039 10TH AVE, COLUMBUS, GA 31901-1459
(706) 566-5764
(706) 566-4377
Mailing address
350 OLD GATE RD, MIDLAND, GA 31820-4777
(706) 580-4059
(706) 566-4377
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33839
GA
Other
Enumeration date
06/15/2018
Last updated
06/15/2018
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