Provider First Line Business Practice Location Address:
262 DANNY THOMAS PLACE
Provider Second Line Business Practice Location Address:
PSYCHOLOGY DEPT.
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-595-3580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2019