PHILIP GLEN BASCOM

ROBINS AFB, GA
NPI1831183623
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ME  LC4245)
Enumeration Date2005-09-07
Last Update Date2010-09-07
Business Address
-- PHILIP GLEN BASCOM LCSW
655 7TH ST BLDG 700
ROBINS AFB, GA 31098-2227
Phone number: 850-461-2083
Mailing Address
-- PHILIP GLEN BASCOM LCSW
655 7TH ST BLDG 700
ROBINS AFB, GA 31098-2227
Phone number: 850-461-2083
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