Provider First Line Business Practice Location Address:
9 MEDICAL DR NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARTERSVILLE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30121-8003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
470-227-1600
Provider Business Practice Location Address Fax Number:
470-227-1606
Provider Enumeration Date:
04/24/2006