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1508105875
WAYNE WASHINGTON
VALDOSTA, GA
NPI
1508105875
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225000000X Orthotic Fitter
(Licence: GA CO040287)
Enumeration Date
2013-02-06
Last Update Date
2013-02-06
Business Address
Mr. WAYNE WASHINGTON
422 E PARK AVE
VALDOSTA, GA 31602-3036
Phone number: 229-247-5374
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Mailing Address
Mr. WAYNE WASHINGTON
422 E PARK AVE
VALDOSTA, GA 31602-3036
Phone number: 229-247-5374
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