Provider First Line Business Practice Location Address:
141 HENRY PARKWAY
Provider Second Line Business Practice Location Address:
HEALTHSTAT CLINIC
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:
704-529-6161
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2019