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General NPI Number Information
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NPI Number | 1255189890
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Entity Type | Organization
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Legal Business Name | THE SAVANNAH TRAUMA INSTITUTE
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Dates
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Enumeration Date | 05/08/2024
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Last Update Date | 05/08/2024
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Provider Practice Location Address
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Address Line | 112 US HIGHWAY 80 W
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City | POOLER
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State | GA
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Zip | 31322-2504
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Country | US
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Telephone | 912-940-4951
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Fax |
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Provider Business Mailing Address
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Address Line | 15 HEADLANDS CT
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City | SAVANNAH
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State | GA
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Zip | 31407-4841
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Country | US
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Telephone | 912-940-4951
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MR. JAY WITT
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Credential |
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Telephone | 912-940-4951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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