Provider First Line Business Practice Location Address:
302 DULLES DR.
Provider Second Line Business Practice Location Address:
DR. JOSEPH TYLER JR. MENTAL HEALTH CENTER
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-362-4100
Provider Business Practice Location Address Fax Number:
337-262-1146
Provider Enumeration Date:
04/11/2007