Provider First Line Business Practice Location Address:
865 POPLAR
Provider Second Line Business Practice Location Address:
MEMPHIS MENTAL HEALTH INSTITUTE
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-524-1200
Provider Business Practice Location Address Fax Number:
901-524-5252
Provider Enumeration Date:
11/16/2006