Provider Demographics
NPI:1538039292
Name:VALDOSTA ADVANCED HEALING INC
Entity type:Organization
Organization Name:VALDOSTA ADVANCED HEALING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CHAVEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:833-381-6736
Mailing Address - Street 1:8801 BALLENTINE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-2082
Mailing Address - Country:US
Mailing Address - Phone:833-381-6736
Mailing Address - Fax:833-381-6628
Practice Address - Street 1:701 BAYTREE RD STE D
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2881
Practice Address - Country:US
Practice Address - Phone:833-381-6736
Practice Address - Fax:833-381-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-07
Last Update Date:2025-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty