Victoria Family Practice Clinic, LLC
NPI #1700119997 in Statesboro, Georgia
Provider Information
- NPI Number
- 1700119997
- Entity Type
- Organization
- Organization Name
- Victoria Family Practice Clinic, LLC
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 7, 2009
- Last Updated
- Jan 20, 2012
Practice Location
- Address
- 23 LESTER RD
- City
- Statesboro
- State
- Georgia
- ZIP Code
- 30458-4700
- Phone
- (912) 225-1836
Authorized Official
- Name
- DR. OSARETIN DANIEL OKUNGBOWA, M.D.
- Title
- OWNER
- Phone
- (912) 225-1836
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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