Provider First Line Business Practice Location Address:
4000 DEKALB TECHNOLOGY PKWY STE 200
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE DEKALB TECHNOLOGY CENTER
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30340-2764
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-496-3580
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/01/2008