Organization
PITTARD CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIDAN H PITTARD (OWNER)
(706) 886-4420
Entity
Organization
Contact information
Practice address
1654 FALLS RD, TOCCOA, GA 30577
(706) 886-4420
(706) 886-4410
Mailing address
1654 FALLS RD, TOCCOA, GA 30577
(706) 886-4420
(706) 886-4410
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
05/04/2020
Last updated
05/04/2020
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