Provider First Line Business Practice Location Address:
3405 MIKE PADGETT HIGHWAY; BUILDING 201
Provider Second Line Business Practice Location Address:
EAST CENTRAL REGIONAL HOSPTIAL
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-792-7073
Provider Business Practice Location Address Fax Number:
706-792-7275
Provider Enumeration Date:
08/10/2015