COLQUITT REGIONAL DERMATOLOGY, LLC

MOULTRIE, GA
NPI1649683897
Entity TypeOrganization
Authorized ContactAMANDA L ROBERTS
Provider Enrollment Coordinator
229-891-9131
Organization Subpart ?Yes
Primary Taxonomy207N00000X Dermatology
Enumeration Date2014-06-05
Last Update Date2022-07-21
Business Address
COLQUITT REGIONAL DERMATOLOGY, LLC
760 26TH AVE SE
MOULTRIE, GA 31768-6799
Phone number: 229-502-9710
Mailing Address
COLQUITT REGIONAL DERMATOLOGY, LLC
760 26TH AVE SE
MOULTRIE, GA 31768-6799
Phone number: 229-502-9710
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