Provider First Line Business Practice Location Address:
WELLSTAR WEST GEORGIA MEDICAL CENTER
Provider Second Line Business Practice Location Address:
1504 VERNON ROAD
Provider Business Practice Location Address City Name:
LAGRANGE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-884-2655
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/30/2015