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Organization

DAY BREAK MEDICAL RESOURCE GROUP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALTHEA DAVIS BROWN (CEO/ADMINISTRATOR)
(706) 267-5931
Entity
Organization

Contact information

Practice address
4349 WHITE PINE CT, AUGUSTA, GA 30906-8122
(706) 267-5931
Mailing address
4349 WHITE PINE CT, AUGUSTA, GA 30906-8122
(706) 267-5931

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN059308
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1720251812
TYPE UNKNOWN/ISSUED FOR US ARMY MEDICAL CENTER
GA
Enumeration date
06/16/2009
Last updated
06/16/2009
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