Individual
JAQVETTA DOUGLAS BADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1285 MARKS CHURCH RD STE E, AUGUSTA, GA 30909-2472
(706) 733-6615
(706) 733-6616
Mailing address
1285 MARKS CHURCH RD STE E, AUGUSTA, GA 30909-2472
(706) 733-6615
(706) 733-6615
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
123582
GA
Other
Enumeration date
08/17/2009
Last updated
08/17/2009
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