Provider First Line Business Practice Location Address:
2197 MARTIN LUTHER KING JR DR SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30310-1143
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-699-1919
Provider Business Practice Location Address Fax Number:
404-699-1402
Provider Enumeration Date:
03/30/2007