Provider First Line Business Practice Location Address:
1000 HALSEY AVE
Provider Second Line Business Practice Location Address:
NBHC NAS ATLANTA
Provider Business Practice Location Address City Name:
MARIETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-655-5317
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/06/2006