Wolf Specific, Inc

NPI 1013283563 - Clinic/Center - 261Q00000X

NPI Details
NPI 1013283563
Enumeration Date 03/29/2012
Last Updated 08/28/2015
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MATTHEW TYLER MATTHEW
Position PRESIDENT
Phone (706) 415-5245
Fax
Practice Location
1697 VERNON RD STE A
LAGRANGE GA, 30240-4180, US
Phone (706) 415-5245
Fax
Business Location
1697 VERNON RD STE A
LAGRANGE GA, 30240-4180, US
Phone (706) 415-5245
Fax (706) 882-1070
Toxanomy
Taxonomy Code 261Q00000X
License State Georgia
License Number CHIR008690
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According to our database, Wolf Specific, Inc NPI is 1013283563, taxonomy code is 261Q00000X and license number is CHIR008690, license state is located at Georgia. Wolf Specific, Inc physically located at 1697 Vernon Rd Ste A, Lagrange GA, 30240-4180. NPI Number 1033115704 has the healthcare provider type.

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1013283563 NPI number is provided on an as is basis without warranty of any kind. 1013283563 is maintained by the National Plan & Provider Enumeration System. The contents of Wolf Specific, Inc are for informational purposes only.