Walley Clinic Pa

NPI 1669463584 - Family Medicine - 207Q00000X

NPI Details
NPI 1669463584
Enumeration Date 10/31/2005
Last Updated 02/27/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name ELETHA JANE ELETHA
Position CEO
Phone (601) 735-2401
Fax (601) 735-5205
Practice Location
920 MATTHEW DR
STE A
WAYNESBORO MS, 39367-2567, US
Phone (601) 735-2401
Fax (601) 735-5205
Business Location
920 MATTHEW DR
STE A
WAYNESBORO MS, 39367-2567, US
Phone (601) 735-2401
Fax (601) 735-5205
Toxanomy
Taxonomy Code 207Q00000X
License State
License Number
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According to our database, Walley Clinic Pa NPI is 1669463584, taxonomy code is 207Q00000X Walley Clinic Pa physically located at 920 Matthew Dr, Waynesboro MS, 39367-2567. NPI Number 1033115704 has the healthcare provider type.

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1669463584 NPI number is provided on an as is basis without warranty of any kind. 1669463584 is maintained by the National Plan & Provider Enumeration System. The contents of Walley Clinic Pa are for informational purposes only.