Provider First Line Business Practice Location Address:
2004 PEACHTREE ROAD, NW, SUITE 100
Provider Second Line Business Practice Location Address:
KASIER PERMANENTE AT PIEDMONT HOSPITAL
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-691-6529
Provider Business Practice Location Address Fax Number:
770-840-7464
Provider Enumeration Date:
05/10/2012