Provider First Line Business Practice Location Address:
552 PONCE DE LEON AVE NE
Provider Second Line Business Practice Location Address:
DIALYSIS ACCESS CTR OF ATLANTA - NEPHROLOGY
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30308-1806
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-872-3655
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2006