WOLF SPECIFIC, INC
Ambulatory Health at Vernon Rd, Lagrange, GA

License number
Georgia CHIR008690
Category
Ambulatory Health
Type
Clinic/Center
Owner
Name: DR. MATTHEW TYLER WOLFERTZ D.C.
Title: PRESIDENT
Phone: (706) 756-5422
Address
Address
1697 Vernon Rd STE A, Lagrange, GA 30240
National Provider ID: 1013283563
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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WOLF SPECIFIC INC

Lagrange, GA

Industry:
Business Services at Non-Commercial Site, Nonclassifiable Establishments
Registration:
Mar 17, 2012
Addresses:
1697 Vernon Rd, Lagrange, GA 30240 (Physical)
117 Lakecrest Dr, Lagrange, GA 30240
State ID:
12024559
Business type:
Domestic Professional Corporation
Presidents:
T Matthew Wolfertz (Secretary), 117 Lakecrest Dr, Lagrange, GA 30240 (Physical),Matthew Wolfertz (President)
Agent:
Matthew Tyler Wolfertz,117 Lk Crst Dr, Lagrange, GA (Physical)

Wolf Specific Inc

PO Box 1010, Lagrange, GA 30241

Industry:
Nonclassifiable Establishments

Ambulatory Health licenses in Georgia


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