Provider First Line Business Practice Location Address:
1610 10TH ST
Provider Second Line Business Practice Location Address:
CLARK-HOLDER CLINIC, P.A.
Provider Business Practice Location Address City Name:
WEST POINT
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31833
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-645-2300
Provider Business Practice Location Address Fax Number:
706-645-2312
Provider Enumeration Date:
08/17/2006