Individual
TAYLOR MACKENZIE BROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5500
(706) 596-5727
Mailing address
2100 COMER AVE, COLUMBUS, GA 31904-8725
(706) 596-5500
(706) 596-5727
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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