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General NPI Number Information
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NPI Number | 1407652530
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Entity Type | Organization
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Legal Business Name | CARE MEDICAL CENTER LLC
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 1622 MADISON AVE
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City | TIFTON
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State | GA
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Zip | 31794-3756
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Country | US
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Telephone | 229-387-8061
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Fax |
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Provider Business Mailing Address
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Address Line | 2808C N OAK ST
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City | VALDOSTA
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State | GA
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Zip | 31602-1716
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Country | US
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Telephone | 229-241-8925
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Fax |
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Authorized Official
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Title or Position | DC, OWNER
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Name | JAMES RYAN MOORMAN
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Credential | DC
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Telephone | 229-241-8925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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