Provider First Line Business Practice Location Address:
3131 S MAIN ST
Provider Second Line Business Practice Location Address:
EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
MOULTRIE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
31768-6925
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-391-1752
Provider Business Practice Location Address Fax Number:
850-273-6357
Provider Enumeration Date:
04/29/2009