Provider First Line Business Practice Location Address:
20 GLENLAKE PARKWAY
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE GLENLAKE MEDICAL CENTER
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-334-1601
Provider Business Practice Location Address Fax Number:
507-334-3071
Provider Enumeration Date:
04/12/2006