Organization
TOMMIE L. WALTON, III INC.
Active
Other names
Recovery Cafe/ Larry Walton and Assoc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOMMIE L. WALTON III LCSW (PRESIDENT/OWNER)
(706) 369-0970
Entity
Organization
Contact information
Practice address
325 N MILLEDGE AVE, ATHENS, GA 30601-3805
(706) 369-0970
(706) 353-1943
Mailing address
PO BOX 7392, ATHENS, GA 30604-7392
(706) 369-0970
(706) 353-1943
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
000692
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004509000
MAGELLAN ID#
GA
Enumeration date
01/26/2007
Last updated
06/20/2008
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