Individual
IFY AGBASI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 323-0174
(706) 323-3264
Mailing address
1330 FREEDOM RIDGE DR, COLUMBUS, GA 31907-6932
(706) 393-9860
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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