Provider First Line Business Practice Location Address:
GRADY MEMORIAL HOSPITAL
Provider Second Line Business Practice Location Address:
8N JESSE HILL DR., RM. CG-20
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-616-7438
Provider Business Practice Location Address Fax Number:
404-616-9084
Provider Enumeration Date:
05/10/2006