Provider First Line Business Practice Location Address:
30 WARREN ST SE
Provider Second Line Business Practice Location Address:
DEKALB GRADY NEIGHBORHOOD HEALTH CENTER
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30317-2267
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-616-9304
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2007