Provider Demographics
NPI:1992535215
Name:GOLDEN ISLES PROSTHETICS & AVERY WATSON STRICKLAND SOLE MBR
Entity type:Organization
Organization Name:GOLDEN ISLES PROSTHETICS & AVERY WATSON STRICKLAND SOLE MBR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:WATSON
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:CPO
Authorized Official - Phone:912-265-2810
Mailing Address - Street 1:2414 PARKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31520-4779
Mailing Address - Country:US
Mailing Address - Phone:912-265-2810
Mailing Address - Fax:912-456-0012
Practice Address - Street 1:2414 PARKWOOD DR
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-4779
Practice Address - Country:US
Practice Address - Phone:912-265-2810
Practice Address - Fax:912-456-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2025-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier