Provider First Line Business Practice Location Address:
1077 S MAIN ST
Provider Second Line Business Practice Location Address:
EMERGENCY ROOM
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30650-2073
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-693-5700
Provider Business Practice Location Address Fax Number:
954-625-6034
Provider Enumeration Date:
10/28/2009