NPI Provider: 1841406287
Contact Name: WADE WANDA
Position: CHIEF
Phone: (706) 544-1421
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Ft Benning Tmc 2 Information:
Ft Benning Tmc 2 organization have npi 1841406287, taxonomy code is 261QM1100X with license number is in . This Business address located in 7950 Martin Loop, Fort Benning, GA 31905 Georgia.
Practice Location
Address: 7950 Martin Loop, Fort Benning, GA 31905
Phone: (706) 544-1421
Business Location
Address: 7950 Martin Loop, Fort Benning, GA 31905
Phone: (706) 544-1421
Taxonomy
Taxonomy Code: 261QM1100X
License Number:
License Number of State:
Primary Taxonomy Switch: Y
Enumeration Date: 5/15/2007
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