Provider First Line Business Practice Location Address:
1175 CASCADE PKWY SW
Provider Second Line Business Practice Location Address:
INTERNAL MEDICINE HEALTH CARE TEAM A
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30311-3090
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-505-4111
Provider Business Practice Location Address Fax Number:
404-505-4192
Provider Enumeration Date:
09/07/2006