Glen  D  King    PHD
Contract Details
Kirkland & King, Clinical & Forensic Psychologists, P.C.
Facility name
Provider ID
P000000905
NPI
1902968795
Tax ID
631045281
Effective Date
2/1/1999
Last Updated
5/31/2013
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_086
Location Details
Address
1520 Mulberry Street
Montgomery, AL 36106
United States
County
Montgomery
Phone
3342691106 (Phone)
Billing Details
Address
Specialty Type
Psychology
Map
Address