Most Relevant Information
Provider Data
| NPI Number: | 1003534736 |
| Provider Name: | CARLTON WILBURN |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/18/2022 |
| Last Updated: | 08/18/2022 |
Provider Practice Location
410 E CHURCH ST
FORT VALLEY
GA
310303097
Practice Location Phone/Fax
| Phone: | 4042779395 |
| Fax: |
Provider Mailing Location
410 E CHURCH ST
FORT VALLEY
GA
310303097
Provider Mailing Phone/Fax
| Phone: | 4042779395 |
| Fax: |