Provider First Line Business Practice Location Address:
2855 CANDLER RD
Provider Second Line Business Practice Location Address:
SUITE 10
Provider Business Practice Location Address City Name:
DECATUR
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30034-1415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-241-7400
Provider Business Practice Location Address Fax Number:
404-241-7475
Provider Enumeration Date:
10/24/2007