Provider First Line Business Practice Location Address:
750 TOWN PARK LANE
Provider Second Line Business Practice Location Address:
PAISER PERMANENTE TOWN PARK MEDICAL OFFICE-DEPT OF AMBU
Provider Business Practice Location Address City Name:
KENNESAW
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30144
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-337-3212
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2009