Provider First Line Business Practice Location Address:
1007 S WILLIAMS
Provider Second Line Business Practice Location Address:
ATLANTA MEMORIAL HOSPITAL
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-799-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/26/2006