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1104464296
CHRISTOPHER BLAKE GLAZE
LAGRANGE, GA
NPI
1104464296
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor Professional
Enumeration Date
2019-12-19
Last Update Date
2019-12-19
Business Address
CHRISTOPHER BLAKE GLAZE
122 GORDON COMMERCIAL DR STE C
LAGRANGE, GA 30240-5754
Phone number: 706-845-4045
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Mailing Address
CHRISTOPHER BLAKE GLAZE
709 S 12TH ST
LANETT, AL 36863-2831
Phone number: 706-590-2839
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