Provider First Line Business Practice Location Address:
233 12TH STREET SUITE 334
Provider Second Line Business Practice Location Address:
THE PSYCHOLOGY CLINIC
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31901-5333
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-225-0322
Provider Business Practice Location Address Fax Number:
706-225-0321
Provider Enumeration Date:
07/09/2014