NPI 1215109087

Valdosta Kidney Clinic, LLC

Organisation Specialist Valdosta, GA

Practice location

Address: 410 Cowart Ave, Valdosta, GA 31602-2622
Phone: (229) 244-6544
Fax: (229) 241-9744
Mailing address: PO Box 2267, Valdosta, GA 31604-2267

Authorised official

Name: Maria Ester Chiang
Title: Manager
Phone: (229) 244-6544

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 054594 (GA)

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Registry record

NPI: 1215109087
Entity type: Organization
NPI issued: 1 Apr 2008
Record last updated: 5 Apr 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.