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: |