ALLERGY & IMMUNOLOGY CENTER PC
Osteopathic Medicine at Palmyra Rd, Albany, GA

License number
Georgia 045992
Category
Osteopathic Medicine
Type
Allergy & Immunology
Owner
Name: JOSE THECKEDATH MD
Title: PRESIDENT/CEO
Phone: (229) 446-7227
Address
Address
1911 Palmyra Rd, Albany, GA 31701
National Provider ID: 1770863276
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ALLERGY & IMMUNOLOGY CENTER, PC

1911 Palmyra Rd, Albany, GA 31701

Registration:
Jul 14, 1999
State ID:
K928907
Business type:
Domestic Professional Corporation
CEO:
M. Jose Theckedath (CEO), 1911 Palmyra Rd, Albany, GA 31701 (Physical)
Agent:
Jose M. Theckedath, M.d,1911 Palmyra Rd, Albany, GA (Physical)

Osteopathic Medicine licenses in Georgia