Provider First Line Business Practice Location Address:
AU HEALTH MEDICAL CTR
Provider Second Line Business Practice Location Address:
1120 FIFTEENTH STREET, BA 8415
Provider Business Practice Location Address City Name:
AUGUSTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30912-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-444-4983
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/02/2016