Provider First Line Business Practice Location Address:
2015 UPPERGATE DR.
Provider Second Line Business Practice Location Address:
DIVISION OF PEDIATRIC NEUROLOGY
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-712-8857
Provider Business Practice Location Address Fax Number:
404-727-1981
Provider Enumeration Date:
04/12/2006