Provider First Line Business Practice Location Address:
1230 BAXTER ST
Provider Second Line Business Practice Location Address:
PATHOLOGY DEPT
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-389-2425
Provider Business Practice Location Address Fax Number:
706-389-2426
Provider Enumeration Date:
02/28/2006