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1609014802
PHILLIP DANIEL STOCKARD
MARTINEZ, GA
NPI
1609014802
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-01-26
Last Update Date
2009-01-26
Business Address
Mr. PHILLIP DANIEL STOCKARD
4145 COLUMBIA RD
MARTINEZ, GA 30907-5400
Phone number: 706-869-7373
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Mailing Address
Mr. PHILLIP DANIEL STOCKARD
4145 COLUMBIA RD
MARTINEZ, GA 30907-5400
Phone number: 706-869-7373
Copy
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