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1124897145
TARA PETTIT DELOACH LLC
AUGUSTA, GA
NPI
1124897145
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Entity Type
Organization
Authorized Contact
TARA PETTIT DELOACH
Owner
706-343-3661
Organization Subpart ?
No
Primary Taxonomy
261QM0850X Clinic/Center, Adult Mental Health
Enumeration Date
2024-01-02
Last Update Date
2024-01-02
Business Address
TARA PETTIT DELOACH LLC
930 STEVENS CREEK RD
AUGUSTA, GA 30907-3200
Phone number: 706-343-3661
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Mailing Address
TARA PETTIT DELOACH LLC
930 STEVENS CREEK RD
AUGUSTA, GA 30907-3200
Phone number: 706-343-3661
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