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General NPI Number Information
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NPI Number | 1508155029
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Entity Type | Organization
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Legal Business Name | MJR ENTERPRISES, PC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 146 DEPOT ST STE 201
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City | BLUE RIDGE
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State | GA
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Zip | 30513-8627
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Country | US
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Telephone | 706-502-9404
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Fax | 949-862-5384
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Provider Business Mailing Address
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Address Line | 146 DEPOT ST STE 201
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City | BLUE RIDGE
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State | GA
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Zip | 30513-8627
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Country | US
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Telephone | 706-502-9404
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Fax | 949-862-5384
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Authorized Official
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Title or Position | OWNER
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Name | MR. A RONALD SEIFERT
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Credential | PHD
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Telephone | 360-698-1321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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