Individual
MR. STEPHEN BOSTICK SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6601 ZEBULON RD, MACON, GA 31220-7606
(478) 476-0805
Mailing address
715 MASON TER APT 32, PERRY, GA 31069-2084
(478) 718-3005
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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