Provider First Line Business Practice Location Address:
4600 FULTON MILL RD
Provider Second Line Business Practice Location Address:
CENTRAL S.P. MENTAL HEALTH DEPT.
Provider Business Practice Location Address City Name:
MACON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31208-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
478-472-2943
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/11/2010