PREMIER CORNERSTONE MANAGEMENT, LLC
Medical Practice at Parker St, Reynolds, GA

License number
Georgia 0101244776
Category
Medical Practice
Type
Obstetrics & Gynecology
License number
Georgia MD424859
Category
Medical Practice
Type
Obstetrics & Gynecology
License number
Georgia 055753
Category
Medical Practice
Type
Obstetrics & Gynecology
Owner
Name: DR. TAWANNA O'PAL GORDON M.D.
Title: OWNER
Phone: (229) 894-7734
Address
Address
66 Parker St, Reynolds, GA 31076
National Provider ID: 1992036396
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PREMIER CORNERSTONE MANAGEMENT, LLC

Reynolds, GA

Status:
Inactive
Industry:
Management Services
Registration:
Apr 23, 2010
Inactive since:
Sep 9, 2012
Addresses:
PO Box 272, Reynolds, GA (Physical)
66 Parker St, Reynolds, GA 31076
State ID:
10030464
Business type:
Domestic Limited Liability Company
Agent:
Tawanna Gordon,66 Parker St, Reynolds, GA 31076 (Physical)