Provider First Line Business Practice Location Address:
414 OLD TOWN ST
Provider Second Line Business Practice Location Address:
MOUNTAIN CREST COUNSELING
Provider Business Practice Location Address City Name:
GUNTERSVILLE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35976
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
256-582-0300
Provider Business Practice Location Address Fax Number:
256-582-0335
Provider Enumeration Date:
07/10/2006