Provider First Line Business Practice Location Address:
115 AMBULANCE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CARROLLTON
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-759-7535
Provider Business Practice Location Address Fax Number:
770-834-7100
Provider Enumeration Date:
07/11/2005