Provider First Line Business Practice Location Address:
1125 TOWN CENTER VILLAGE DR
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE TOWNE CENTRE MEDICAL CENTER
Provider Business Practice Location Address City Name:
MCDONOUGH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30253-5970
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-583-6579
Provider Business Practice Location Address Fax Number:
216-362-2716
Provider Enumeration Date:
05/14/2009