Our Lady of the Roses Primary Care

NPI #1205207933 in Columbus, Georgia

Provider Information

NPI Number
1205207933
Entity Type
Organization
Organization Name
Our Lady of the Roses Primary Care
Primary Specialty
Clinic/Center - Migrant Health
Enumeration Date
Oct 7, 2015
Last Updated
Oct 7, 2015

Practice Location

Address
808 21ST ST
State
Georgia
ZIP Code
31904-8817
Phone
(706) 587-5771

Authorized Official

Name
MR. GERALD WILLIAM WIECZOREK
Title
BUSINESS MANAGER
Phone
(706) 327-4880

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Migrant HealthMigrant Health

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