Provider First Line Business Practice Location Address:
20 GLENLAKE PARKWAY
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE GLENLAKE
Provider Business Practice Location Address City Name:
SANDY SPRINGS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-454-0024
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/04/2006