SOUTHERN PEDIATRIC CLINIC, LLC

VALDOSTA, GA
NPI1982858767
Entity TypeOrganization
Authorized ContactCHARLENE C BLACHE
Owner/Physician
229-241-0059
Organization Subpart ?No
Primary Taxonomy208000000X Pediatrics
Enumeration Date2008-11-06
Last Update Date2017-02-03
Business Address
SOUTHERN PEDIATRIC CLINIC, LLC
406 M NORTHSIDE DRIVE
VALDOSTA, GA 31602
Phone number: 229-241-0059
Mailing Address
SOUTHERN PEDIATRIC CLINIC, LLC
406 M NORTHSIDE DRIVE
VALDOSTA, GA 31602
Phone number: 229-241-0059
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