Provider First Line Business Practice Location Address:
3950 AUSTELL RD
Provider Second Line Business Practice Location Address:
HOSPITAL BASED ONLY WELLSTAR COBB HOSPITAL
Provider Business Practice Location Address City Name:
AUSTELL
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-732-4415
Provider Business Practice Location Address Fax Number:
770-732-4421
Provider Enumeration Date:
06/08/2006