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1629528450
KELLY WIEDOWER
GREENSBORO, GA
NPI
1629528450
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: GA 213342)
Enumeration Date
2016-10-05
Last Update Date
2016-10-05
Business Address
-- KELLY WIEDOWER
1041 PARK DR
GREENSBORO, GA 30642-3465
Phone number: 706-453-4945
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Mailing Address
-- KELLY WIEDOWER
1081 PRINCETON LN
WATKINSVILLE, GA 30677-5338
Phone number: 706-254-3250
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