Provider First Line Business Practice Location Address:
1440 CLIFTON RD NE STE 111
Provider Second Line Business Practice Location Address:
EMORY SCHOOL OF MEDICINE
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30322-1053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-655-8873
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/28/2007