Provider First Line Business Practice Location Address:
11 UPPER RIVERDALE RD SW
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
RIVERDALE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30274-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-423-1550
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/01/2006