KELLY WIEDOWER

GREENSBORO, GA
NPI1629528450
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: GA  213342)
Enumeration Date2016-10-05
Last Update Date2016-10-05
Business Address
-- KELLY WIEDOWER
1041 PARK DR
GREENSBORO, GA 30642-3465
Phone number: 706-453-4945
Mailing Address
-- KELLY WIEDOWER
1081 PRINCETON LN
WATKINSVILLE, GA 30677-5338
Phone number: 706-254-3250