PHILLIP TATE WELLER

AUGUSTA, GA
NPI1780339010
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: GA  DN122883)
Enumeration Date2022-02-15
Last Update Date2022-11-04
Business Address
PHILLIP TATE WELLER
1120 15TH ST # GC5110
AUGUSTA, GA 30912-0004
Phone number: 435-659-4336
Mailing Address
PHILLIP TATE WELLER
1120 15TH ST # GC5110
AUGUSTA, GA 30912-0004
Phone number:
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