Provider First Line Business Practice Location Address:
135 N PAULINE ST FL 4
Provider Second Line Business Practice Location Address:
COMMUNITY BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38105-4619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-577-6167
Provider Business Practice Location Address Fax Number:
901-577-6180
Provider Enumeration Date:
02/14/2007