Individual
TITO TERRY
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) 256-3264
Mailing address
2839 AUBURN AVE, COLUMBUS, GA 31906-1332
(706) 577-7258
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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