Provider First Line Business Practice Location Address:
1125 TOWNE CENTER VILLAGE DRIVE
Provider Second Line Business Practice Location Address:
KAISER PERMANENTE HENRY TOWNE CENTRE MEDICAL CENTER
Provider Business Practice Location Address City Name:
MCDONOUGH
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30253
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-583-6245
Provider Business Practice Location Address Fax Number:
478-923-9977
Provider Enumeration Date:
05/04/2006