Provider First Line Business Practice Location Address:
2142 W BROAD ST BLDG 200
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE ATHENS MEDICAL CENTER
Provider Business Practice Location Address City Name:
ATHENS
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30606-3509
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
706-583-5000
Provider Business Practice Location Address Fax Number:
229-391-3686
Provider Enumeration Date:
04/11/2006