VICKIE CONSUELLA71 BUSH

VALDOSTA, GA
NPI1912464702
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy253Z00000X In Home Supportive Care
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: GA  456669)
Enumeration Date2019-02-27
Last Update Date2019-02-28
Business Address
VICKIE CONSUELLA71 BUSH
3701 BERMUDA RUN DR
VALDOSTA, GA 31605-1059
Phone number: 229-292-0021
Mailing Address
VICKIE CONSUELLA71 BUSH
3701 BERMUDA RUN DR
VALDOSTA, GA 31605-1059
Phone number: 229-292-0021