Provider First Line Business Practice Location Address:
1514 VERNON RD
Provider Second Line Business Practice Location Address:
WELLSTAR WEST GEORGIA MEDICAL CENTER - REHAB SERVICES
Provider Business Practice Location Address City Name:
LAGRANGE
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30240-4131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-845-3862
Provider Business Practice Location Address Fax Number:
706-845-3700
Provider Enumeration Date:
08/02/2016