Provider First Line Business Practice Location Address:
1446 HARPER STREET, BT-2641
Provider Second Line Business Practice Location Address:
CHILDREN'S HOSPITAL OF GEORGIA
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-721-4402
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/18/2005