Provider First Line Business Practice Location Address:
3807 CLAIRMONT ROAD
Provider Second Line Business Practice Location Address:
NORTH DEKALB GRADY CLINIC
Provider Business Practice Location Address City Name:
CHAMBLEE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30341
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-616-0700
Provider Business Practice Location Address Fax Number:
404-616-3078
Provider Enumeration Date:
08/22/2006