Provider First Line Business Practice Location Address:
3640 TRAMORE POINTE PARKWAY
Provider Second Line Business Practice Location Address:
KAISER PERMANENT WEST COBB MEDICAL CENTER
Provider Business Practice Location Address City Name:
AUSTELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-514-5460
Provider Business Practice Location Address Fax Number:
770-439-4712
Provider Enumeration Date:
09/25/2006