Provider First Line Business Practice Location Address:
DEPARTMENT OF SURGERY, BI 4076
Provider Second Line Business Practice Location Address:
MEDICAL COLL OF GEORGIA, 1102 15TH STREET
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:
706-721-4651
Provider Business Practice Location Address Fax Number:
706-721-2063
Provider Enumeration Date:
08/22/2006